2023-2024 ATI Community Health Practice Exam Version-6-13 With Answers-340 Solved Questions

VERSIONS 6-13
VERSION 6
ATI COMMUNITY HEALTH
1. A nurse is counseling a client who is to undergo enzyme linked immunosorbent assay
testing for HIV. Which of the following information should the nurse include?
A) A positive result requires initiating immunoglobulin administration.
B) The test measures antibodies to the virus.
C) The test monitors progression of the disease.
D) The test results are accurate 24 hr after exposure to the virus.
Answer: B) The test measures antibodies to the virus.
2. A community health nurse is providing teaching to a group of clients who have alcohol use
disorder. Which of the following findings should the nurse include in the teaching as a
manifestation of alcohol withdrawal?
A) Bradycardia
B) Increased appetite
C) Hypothermia
D) Insomnia
Answer: D) Insomnia.
3. A home health nurse is caring for a client who has chemotherapy-induced nausea that has
been resistant to relief from pharmacological measures. Which of the following interventions
should the nurse initiate? (Select all that apply.)
A) Provide sips of room-temperature ginger ale between meals.
B) Use seasonings to enhance the flavor of foods.
C) Offer 120 mL (4 oz) of cold 2% milk as a meal replacement.
D) Maintain the head of the client's bed in an elevated position after eating.
E) Assist the client in using guided imagery.
Answer: A) Provide sips of room-temperature ginger ale between meals.

4. A community health clinic nurse manager is reviewing the incidence rate of chlamydia in
the state. In a given year, 3,144 new cases were reported and the population was estimated at
325,986. Which of the following is the incidence rate in the state for the year?
A) About 1 reported case per 10,000 population
B) About 300 reported cases per 100,000 population
C) About 10 reported cases per 1,000 population
D) About 3 reported cases per 10,000 population
Answer: A) About 1 reported case per 10,000 population.
5. A nurse is working in a shelter following a disaster. Which of the following is the priority
action for the nurse to take?
A) Address the physical needs of clients.
B) Create diversionary activities for children.
C) Help clients gather needed supplies.
D) Explore feelings the clients are experiencing.
Answer: A) Address the physical needs of clients.
6. A client who has diabetes mellitus asks a home health nurse to help her adapt some of her
traditional cultural foods to fit her meal plan. Which of the following is the first action the
nurse should take when assisting this client?
A) Use cookbooks to include traditional foods in meal plans.
B) Observe the client during preparation of traditional foods.
C) Provide the client with printed recipes.
D) Explain the diabetes exchange list.
Answer: D) Explain the diabetes exchange list.
7. A school nurse is implementing health screenings. Which of the following assessment
findings should the nurse recognize as the highest priority?
A) A child who has nits.
B) An adolescent who has scoliosis.
C) A child who has a BMI of 18.
D) An adolescent who has psoriasis.
Answer: A) A child who has nits.

8. A 35-year-old client who has a diagnosis of tuberculosis informs the provider's office that
she is unable to pay for the treatment. Which of the following actions by the nurse will
facilitate obtaining appropriate treatment?
A) Arrange for medication through local agencies.
B) Send the client to the nearest facility for further evaluation.
C) Explore options for alternative therapies.
D) Help the client apply for Medicare.
Answer: A) Arrange for medication through local agencies.
9. A nurse is providing education to a group of adolescents who are pregnant and attending
high school. Which of the following information should the nurse include in the teaching?
A) Caffeinated beverages should be replaced with caffeine-free beverages.
B) The need for supplemental folic acid is greatest during the third trimester.
C) The incidence of high birth weight infants is higher in adolescent pregnancy.
D) Pregnant adolescents need to gain less weight than adult mothers.
Answer: C) The incidence of high birth weight infants is higher in adolescent pregnancy.
10. A nurse is caring for a client who is having difficulty performing activities of daily living.
The nurse is functioning in which of the following roles when arranging for an occupational
therapist to visit the client?
A) Administrator
B) Clinician
C) Nurse consultant
D) Case manager
Answer: D) Case manager.
11. A home health nurse is scheduled for a first-time visit to a client. Which of the following
should the nurse perform first?
A) Mental status examination
B) Review of the neighborhood
C) Blood pressure screening
D) Family history
Answer: B) Review of the neighborhood.

12. A nurse at a community clinic is preparing an educational guide about cultural variances
in expression of pain. Which of the following information should the nurse include?
A) Native American cultural practices include being outspoken about pain.
B) Chinese cultural practices include enduring pain to prevent family dishonor.
C) Puerto Rican cultural practices include the view that outspoken expressions of pain are
shameful.
D) Middle Eastern cultural practices include hiding pain from close family members.
Answer: B) Chinese cultural practices include enduring pain to prevent family dishonor.
13. A school nurse is planning safety education for a group of adolescents. The nurse should
give priority to which of the following topics as the leading cause of death for this age group?
A) Substance abuse prevention
B) Sports injury prevention
C) Gun safety
D) Motor vehicle safety
Answer: D) Motor vehicle safety.
14. A nurse at a local health department is caring for several clients. Which of the following
infections should the nurse report to the state health department?
A) Human papillomavirus
B) Group B streptococcus B-hemolytic
C) Herpes simplex virus
D) Chlamydia
Answer: D) Chlamydia.
15. The partner of an older adult client who has Alzheimer's disease reports that he is not
eating. The home health aide tells the nurse that the client's partner refuses to assist the client
with feeding. The partner insists the client feed himself without help. Which of the following
is the priority action the nurse should take?
A) Arrange for Meals on Wheels assistance.
B) Refer the client's partner to an Alzheimer's support group.
C) Direct the home health aide to assist with meals.
D) Determine the client’s ability to self-feed.
Answer: B) Refer the client's partner to an Alzheimer's support group.

16. A clinic nurse is assessing a client who has measles. Which of the following findings
should the nurse expect?
A) Muscle aches and tenderness
B) Koplik spots inside the mouth
C) Rash confined to the trunk of the body
D) Persistent low-grade temperature
Answer: B) Koplik spots inside the mouth.
17. A community health nurse is interviewing a client who reports intimate partner abuse.
Which of the following actions should the nurse take?
A) Ask three nurses of the same gender as the client to participate in the interview.
B) Communicate disapproval of the partner's actions.
C) Record a summary of the client’s description of the event.
D) Assist the client to create a plan of escape.
Answer: C) Record a summary of the client’s description of the event.
18. A nurse in a mobile health clinic is caring for a client who requires a tetanus
immunization and is accompanied by his daughter. The client does not speak the same
language as the nurse. Which of the following actions should the nurse take?
A) Arrange for a member of the client's community to interpret the teaching.
B) Have the client’s daughter communicate information about the procedure.
C) Use professional terminology when providing education prior to the procedure.
D) Identify the client's spoken dialect prior to contacting an interpreter.
Answer: A) Arrange for a member of the client's community to interpret the teaching.
19. A nurse is working with a community health care team to devise strategies for preventing
violence in the community. Which of the following interventions is an example of tertiary
prevention?
A) Assessing for risk factors of intimate partner abuse during health examinations
B) Developing resources for victims of abuse
C) Urging community leaders to make nonviolence a priority
D) Presenting community education programs about stress management
Answer: B) Developing resources for victims of abuse.

20. A nurse is discussing short- and long-term goals with a client who has alcohol use
disorder and is being admitted to a treatment facility. Which of the following statements is
appropriate for the nurse to include in the discussion?
A) "You will begin learning functional skills to replace defense mechanisms and behaviors
while in treatment."
B) "Attending Al-Anon meetings will help you identify a role model to assist you with
making needed changes."
C) "Remaining physically active will help to minimize drowsiness and cravings associated
with initial alcohol withdrawal."
D) "You will be taking a once weekly dose of disulfiram to help control withdrawal
symptoms during treatment."
Answer: B) "Attending Al-Anon meetings will help you identify a role model to assist you
with making needed changes."
21. A home health nurse is planning the initial home visit for a client who has dementia and
lives with his adult son's family. Which of the following actions should the nurse take first
during the visit?
A) Engage the family in informal conversation.
B) Provide the family with information about respite care.
C) Encourage the family to join a support group.
D) Educate the family regarding the progression of dementia.
Answer: A) Engage the family in informal conversation.
22. A nurse is planning a program about healthy eating at an elementary school where most
students select French fries and pizza at lunch every day. Which of the following actions
should the nurse plan to take first?
A) Provide students with resources about making wise choices independently.
B) Help students recognize the value of making healthy food choices.
C) Give positive feedback to students who make appropriate choices.
D) Determine students' motivation to learn about healthy food choices.
Answer: B) Help students recognize the value of making healthy food choices.

23. Several nurses are developing a parish nurse group to help address the primary and
secondary health care needs of the congregation. Which of the following services should the
nurses plan to provide to the congregation?
A) Facilitate discharge from the facility to the home.
B) Perform wound care in the home of members.
C) Organize an influenza immunization clinic with the American Red Cross.
D) Provide end-of-life care for members who are terminal.
Answer: D) Provide end-of-life care for members who are terminal.
24. A nurse is counseling a client who has a new diagnosis of chlamydia. Which of the
following information should the nurse include in the teaching? (Select all that apply.)
A) "You will need to take an antiviral medication for 30 days."
B) "You might experience painful urination until the infection has resolved."
C) "Once you complete treatment, you will have acquired immunity against chlamydia."
D) "Notify anyone with whom you have had sexual contact over the past 2 months."
E) "You should avoid sexual contact until therapy is complete."
Answer: D) "Notify anyone with whom you have had sexual contact over the past 2 months."
E) "You should avoid sexual contact until therapy is complete."
25. A nurse case manager is providing discharge planning for a client. The nurse is
functioning in which of the following roles when arranging for the delivery of medical
equipment to the client's home?
A) Consultant
B) Advocate
C) Coordinator
D) Systems allocator
Answer: D) Systems allocator.
26. A nurse is working with a case manager for a client who participates in a health
maintenance organization. The nurse should identify that a health maintenance organization
provides which of the following payment structures?
A) The provider bills the client directly for a predetermined percentage of the cost of
services.
B) The provider is paid a fixed sum for the client on a monthly or yearly basis.

C) The client is participating in a fee-for-service health care insurance program.
D) The client pays the insurer a percentage of the total costs for each service rendered by the
provider.
Answer: B) The provider is paid a fixed sum for the client on a monthly or yearly basis.
27. A community health nurse is providing screening for lipid disorders. Which of the
following is the primary goal of this activity?
A) Client enrollment in prevention programs
B) Identification of family history of medical problems
C) Early detection of disease
D) Promotion of appropriate lifestyle changes
Answer: C) Early detection of disease.
28. A community health nurse is planning a smoking cessation class. Which of the following
factors will have the greatest effect on the success of the class?
A) Clients' motivation
B) Presenter's credibility
C) Presenter's teaching strategies
D) Clients' education level
Answer: A) Clients' motivation.
29. A home health nurse manager is caring for a client who has methicillin-resistant
Staphylococcus aureus. Which of the following actions should the nurse take?
A) Remove fresh flowers from the client's home.
B) Double bag soiled dressings in polyethylene bags.
C) Wear a mask when within 3 feet of the client.
D) Encourage the client to use a HEPA filter in the house.
Answer: A) Remove fresh flowers from the client's home.
30. A community health nurse is planning an educational program for a group of women who
are postmenopausal. Which of the following outcomes is appropriate for this program?
A) Clients will schedule bone density screenings.
B) Clients will significantly decrease caloric intake.
C) Clients will start hormone replacement therapy.

D) Clients will arrange for mammograms every 3 years.
Answer: A) Clients will schedule bone density screenings.
31. A community health nurse is caring for clients in a culturally diverse community. Which
of the following actions demonstrates accurate cultural knowledge about a specific cultural
group?
A) Including both hot and cold food items on a Hispanic client's menu.
B) Maintaining eye contact when interviewing a Native American client.
C) Touching the hair of an African-American client during an assessment.
D) Offering to shake hands when meeting an Asian client of the opposite gender.
Answer: A) Including both hot and cold food items on a Hispanic client's menu.
32. A community health nurse is planning a program for adolescents about preventing STIs.
Which of the following actions should the nurse take first?
A) Establish methods to evaluate program outcomes.
B) Collect data to identify barriers to learning.
C) Provide computer-based education.
D) Obtain visual aids that feature adolescents.
Answer: B) Collect data to identify barriers to learning.
33. A nurse is serving on a state task force for disaster planning. The nurse is engaging in
disaster preparedness efforts when performing which of the following actions?
A) Implementing a disaster triage plan with a local medical facility.
B) Assisting with the identification of a biological agent.
C) Organizing a mass casualty drill for community members.
D) Functioning as a manager at a temporary shelter.
Answer: C) Organizing a mass casualty drill for community members.
34. A nurse is conducting a community assessment. Which of the following information
should the nurse include as part of a windshield survey?
A) Housing quality.
B) Informant interviews.
C) Demographic data.
D) Mortality rate.

Answer: A) Housing quality.
35. A nurse at a shelter is assisting with client triage after a tornado destroyed a community.
Which of the following clients should receive priority care?
A) A school-age client who has a head abrasion.
B) An older adult client who has a fractured arm.
C) An adult client who is short of breath.
D) An infant client who is crying.
Answer: C) An adult client who is short of breath.
36. A parish nurse is counseling a family following a client's recent diagnosis of heart disease.
Which of the following actions should the nurse take first?
A) Discuss the benefits of eating a well-balanced diet with the client’s family.
B) Assist the client and the client’s partner with finding an affordable exercise program.
C) Offer to accompany the client and the client’s partner during health care provider visits.
D) Ask family members about the impact of the disease on relationships within the family.
Answer: D) Ask family members about the impact of the disease on relationships within the
family.
37. A nurse is planning a primary prevention strategy for reducing obesity in a community.
Which of the following strategies should the nurse use?
A) Encourage enrollment and attendance at weight-reduction programs.
B) Measure the BMI of older adults at a community senior center.
C) Distribute health-risk appraisal questionnaires at community functions.
D) Educate children at a day care center about nutrition and exercise.
Answer: D) Educate children at a day care center about nutrition and exercise.
38. A nurse working in an infectious disease clinic is caring for a client who has a new
diagnosis of Lyme disease. Which of the following agencies is responsible for voluntarily
reporting cases of this disease to the Centers for Disease Control and Prevention?
A) Office of the Surgeon General.
B) Local Red Cross chapter.
C) State health department.
D) Hospital infection control department.

Answer: C) State health department.
39. An occupational health nurse is discussing health promotion with a client who has a
history of obesity. Which of the following comments indicates the client is using
rationalization as a coping mechanism?
A) "I know you don’t like me because I am obese."
B) "I am obese because it’s in my genes."
C) "I have difficulty resisting the items in vending machines."
D) "I have lots of health problems from being obese."
Answer: B) "I am obese because it’s in my genes."
40. A nurse is caring for a client who is homeless. Which of the following actions should the
nurse take first?
A) Determine the client’s understanding of her living situation.
B) Assist the client to develop goals for obtaining shelter.
C) Develop client teaching using a variety of strategies.
D) Discuss the risks of being homeless with the client.
Answer: B) Assist the client to develop goals for obtaining shelter.
41. In the last month, three cases of tuberculosis have been referred to the Health Department.
Which of the following is the priority information for the community health nurse to obtain
from each client?
A) Demographics
B) Health history
C) Household members
D) Occupation
Answer: C) Household members
42. A government official reports to the health department that an employee was possibly
exposed to anthrax. Which of the following actions should a public health nurse take?
A) Instruct the client to wear a mask at work.
B) Refer coworkers who might have been exposed to a provider for prophylactic antibiotics.
C) Place the employee under quarantine for 14 days.
D) Alert the family members of coworkers about their possible exposure to anthrax.

Answer: B) Refer coworkers who might have been exposed to a provider for prophylactic
antibiotics.
43. A client arrives at a mental health clinic and tells the nurse that she has no purpose in life.
Which of the following is the nurse’s priority response?
A) Tell me what is going on with you right now.
B) How long have you been feeling this way?
C) Have you been thinking about harming yourself?
D) Do you really think your life has no purpose?
Answer: C) Have you been thinking about harming yourself?
44. A community health nurse is educating a parent about the importance of hepatitis B
immunization. Which of the following explanations should the nurse give the parent about
the disease?
A) Many people who acquire acute hepatitis B develop chronic hepatitis.
B) Hepatitis B spreads easily among children through casual contact.
C) People who have had a hepatitis B infection still need the immunization.
D) One dose of the immunization gives children lifelong protection from hepatitis B.
Answer: A) Many people who acquire acute hepatitis B develop chronic hepatitis.
45. A home health nurse is visiting a client who had a stroke 2 months ago. Which of the
following findings should the nurse report to the interprofessional care team?
A) The client dresses her affected side first.
B) The client’s caregiver fills a pill organizer weekly.
C) The client coughs when swallowing her medications.
D) The client bears weight on her arms when using crutches.
Answer: C) The client coughs when swallowing her medications.
46. A nurse manager in a local community health agency is creating a job description for a
new nurse who will practice community-oriented nursing. Which of the following should the
nurse include in the job description? (Select all that apply.)
A) Provide health-related education to community groups.
B) Participate in local health surveillance activities.
C) Initiate support groups for parents of autistic children.

D) Investigate potential health and environmental issues.
E) Provide wound care for clients in their homes.
Answer: A) Provide health-related education to community groups.
B) Participate in local health surveillance activities.
C) Initiate support groups for parents of autistic children.
D) Investigate potential health and environmental issues.
47. During a home health visit, a school-age child who has muscular dystrophy confides in
the nurse that he was struck by his parent. Which of the following actions should the nurse
take first?
A) Enroll the parent in anger management classes.
B) Refer the parent to a social service agency.
C) Check the child for injuries.
D) Report the incident to local authorities.
Answer: C) Check the child for injuries.
48. A faith-based organization asks a community health nurse to develop a mobile meal
program for older adults who are no longer driving. Which of the following actions should
the nurse plan to take first?
A) Identify alternative solutions to address concerns.
B) Inquire about the availability of volunteers.
C) Perform a needs assessment.
D) Determine potential funding sources for the program.
Answer: C) Perform a needs assessment.
49. A first response team is working at the location of a bombing incident. A nurse triaging a
group of clients should give treatment priority to which of the following clients?
A) A client who has a femur fracture with a 2+ pedal pulse.
B) A client who is ambulatory and exhibits manic behavior.
C) A client who has a rigid abdomen with manifestations of shock.
D) A client who has superficial partial-thickness burn injuries over 5% of his body.
Answer: C) A client who has a rigid abdomen with manifestations of shock.

50. A newly hired occupational health nurse is assessing hazards in the work environment.
Which of the following actions will help the nurse detect potential physical hazards?
A) Track rates of illness caused by infection among employees.
B) Measure noise levels at various locations in the workplace.
C) Identify industrial toxins that are present in the environment.
D) Survey workers about job-related emotional stress.
Answer: B) Measure noise levels at various locations in the workplace.
51. A nurse is providing teaching to a 50-year-old female client. Which of the following
statements should the nurse include in the teaching?
A) You should have your hearing screened every 5 years.
B) You should have your stool tested for blood every other year until the age of 74.
C) You should have your fasting blood glucose level checked every 6 years.
D) You should have a complete eye examination every 2 years until the age of 64.
Answer: B) You should have your stool tested for blood every other year until the age of 74.
52. A nurse is preparing an educational program about breastfeeding for a group of new
parents. The nurse should use which of the following instructional strategies to promote
psychomotor learning?
A) Provide dolls for the participants to demonstrate positioning.
B) Show the group a video on breastfeeding techniques.
C) Review flashcards that identify holding techniques with the group.
D) Facilitate a discussion group about the benefits of breastfeeding.
Answer: A) Provide dolls for the participants to demonstrate positioning.
53. A community health nurse observes the accumulation of garbage at a neighborhood
playground. Which of the following actions should the nurse take first to promote a clean and
safe environment?
A) Partner city officials with community members to improve the playground's condition.
B) Engage neighborhood families to monitor the playground for further trash buildup.
C) Meet with community members to discuss methods of playground maintenance.
D) Work with local businesses to sponsor more trash receptacles in the playground.
Answer: A) Partner city officials with community members to improve the playground's
condition.

54. A nurse is working to reduce individual and family violence in the local community.
Which of the following actions by the nurse demonstrates a primary prevention strategy to
achieve this goal?
A) Assessing a family for marital discord.
B) Teaching parenting techniques to new parents.
C) Conducting counseling for at-risk parents.
D) Providing treatment for a young adult who has a substance use disorder.
Answer: B) Teaching parenting techniques to new parents.
55. A nurse is triaging clients who were involved in a commuter train crash. Which of the
following clients should the nurse choose for transport to the emergency department first?
A) A client who has a fracture of the humerus with a 2+ radial pulse in the affected arm.
B) A client who has full-thickness burn injuries over 30% of his total body surface area.
C) A client who is exhibiting agonal respirations with fixed and dilated pupils.
D) An ambulatory client who has a nosebleed and reports feeling dizzy.
Answer: C) A client who is exhibiting agonal respirations with fixed and dilated pupils.
56. A community health nurse is working with a group of homeless veterans who have
posttraumatic stress disorder. Which of the following interventions should the nurse
implement?
A) Provide coffee and snacks during the meetings.
B) Teach the clients to practice deep breathing exercises.
C) Avoid discussing traumatic events experienced by the veterans.
D) Change the meeting sites frequently.
Answer: B) Teach the clients to practice deep breathing exercises.
57. A nurse is providing education to the family of a school-age child who has pertussis.
Which of the following information should the nurse include in the teaching?
A) The child is most contagious after the rash develops.
B) A dehumidifier should be placed beside the child's bed.
C) Transmission will be limited because of herd immunity.
D) Household contacts will receive prophylactic antibiotics.
Answer: D) Household contacts will receive prophylactic antibiotics.

58. A nurse is assessing an outbreak of mumps among school-age children. Using the
epidemiological triangle, the nurse should recognize that which of the following is the host?
A) The virus.
B) The children.
C) The vaccine.
D) The school.
Answer: B) The children.
59. An occupational health nurse is assessing agricultural workers for acute effects of
pesticide exposure. Which of the following findings should the nurse expect?
A) Oliguria.
B) Dizziness.
C) Diplopia.
D) Hypoglycemia.
Answer: B) Dizziness.
60. A public health nurse is addressing community leaders at a forum about community
improvement. The nurse should identify which of the following groups as being the fastestgrowing segment of the homeless population?
A) People who have substance use disorders.
B) Men who are unemployed.
C) Adolescent runaways.
D) Families who have children.
Answer: D) Families who have children.

VERSION 7
ATI COMMUNITY HEALTH PROCTORED PRACTICE ASSESSMENT B1
1. A school nurse is discussing levels of prevention with a teacher. Which of the following
activities should the nurse identify as a primary prevention strategy?
A) Provide nutritional counseling for students who have diabetes
B) Report suspected child neglect to the proper authorities

C) Conduct vision and hearing screening for kindergarten enrollment
D) Demonstrate proper handwashing techniques
Answer: D) Demonstrate proper handwashing techniques
2. A school nurse is conducting hearing screening procedures in an elementary school. Which
of the following instructions should the nurse provide when performing the Rinne test?
A) "After I place the tuning fork on your scalp, tell me if you hear the sound better in one ear
or the same in both ears."
B) "Use your finger to close one ear while I whisper some numbers into your other ear."
C) "After I place this tuning fork behind your ear, tell me when you no longer hear the
sound."
D) "You'll wear headphones and press the button when you hear a sound."
Answer: C) "After I place this tuning fork behind your ear, tell me when you no longer hear
the sound."
3. A palliative care nurse is teaching a client who has cancer about the services that are
available for the client. Which of the following statements should the nurse identify as an
indication that the client understands the teaching?
A) "If I begin palliative care, I will have to stop my chemotherapy."
B) "I can begin palliative care when I have less than 6 months to live."
C) "This type of care can help me with pain control."
D) "My family will not be involved with this type of care program."
Answer: C) "This type of care can help me with pain control."
4. A nurse is assessing a new client. Which of the following information should the nurse
include in the cultural portion of the assessment?
A) Food preferences
B) Employment status
C) History of illness
D) Sexual orientation
Answer: A) Food preferences
5. A nurse is collecting demographic data as a part of a community assessment. Which of the
following information should the nurse include?

A) Racial distribution
B) Family genograms
C) Number of open water sources
D) Presence of condemned buildings
Answer: A) Racial distribution
6. A nurse is caring for a client who has AIDS and is experiencing rapid weight loss. Which
of the following actions should the nurse take first?
A) Examine the client's oral mucous membranes
B) Encourage the client to consume 1.2-2.0 g/kg of protein daily
C) Recommend the client increase her daily calorie intake by 25%
D) Teach the client about findings that should be reported to the provider
Answer: A) Examine the client's oral mucous membranes
7. A home health nurse is caring for a client who has breast cancer. Which of the following
assessment findings should the nurse identify as an indication that the client is coping
effectively?
A) Inability to concentrate
B) Makes eye contact
C) Excessive sleeping
D) Lack of interest in food
Answer: B) Makes eye contact
8. A home health nurse is scheduling client visits for the day. Which of the following clients
should the nurse plan to visit first?
A) A client who is 10 days postop following a mastectomy and needs to have surgical staples
removed
B) A client who has DM and reports new erythema to the left foot
C) A client who has COPD and needs a follow-up visit regarding home oxygen therapy
D) A client in a hip spica cast who reports pruritus under the cast
Answer: B) A client who has DM and reports new erythema to the left foot

9. A community health nurse is assessing a group of clients for risk factors of abusive
behaviors. Which of the following findings should the nurse identify as a risk factor for
developing violent behavior?
A) A client states he witnessed his mother physically mistreat his father
B) A client states that her mother-in-law provides childcare while she is working
C) A client participates in volunteer activities in the community
D) A client lives in the same neighborhood where he spent his childhood years
Answer: A) A client states he witnessed his mother physically mistreat his father
10. A school nurse is teaching health promotion to a group of staff members who sit at a desk
and use a computer for 8 hours at a time. Which of the following information is the priority
for the nurse to include?
A) "Take a walk after work."
B) "Point and flex your toes periodically."
C) "Have your visual acuity assessed regularly."
D) "Adjust your chair so that your elbows are at desk height."
Answer: B) "Point and flex your toes periodically."
11. A case manager is planning an educational program for a client who has diabetes mellitus
(DM). Which of the following activities should the nurse include when using the
psychomotor domain of learning?
A) Review a color diagram of the food pyramid with the client
B) Show the client a video about how to monitor blood glucose levels
C) Observe the client's technique for drawing up insulin
D) Give the client a pamphlet about foot care
Answer: C) Observe the client's technique for drawing up insulin
12. A nurse manager at a community health clinic is presenting an in-service for nurses about
assessing clients for abuse. Which of the following statements by a nurse indicates an
understanding of the teaching?
A) "Once I determine that a client is not at risk for abuse, I do not need to ask about it at
future visits."
B) "I should not document the name of the person the client accuses of the abuse in the
client's medical record."

C) "I should wait until I see signs of physical abuse before I help the client develop a safety
plan."
D) "I should refer a client for a rape kit examination if she reports sexual assault within the
previous 24 hours."
Answer: D) "I should refer a client for a rape kit examination if she reports sexual assault
within the previous 24 hours."
13. A nurse is teaching a client who has a new diagnosis of hepatitis A how to prevent the
spread of the virus. Which of the following instructions should the nurse include?
A) "Rinse your toothbrush with hydrogen peroxide after each use."
B) "Clean your bathroom fixtures with a chlorine bleach solution."
C) "Use shared hand towels to dry your hands after washing."
D) "Use condoms during sexual contact for 2 weeks."
Answer: B) "Clean your bathroom fixtures with a chlorine bleach solution."
14. A community health nurse is developing a plan of care for a client who is Hispanic.
Which of the following actions should the nurse include in the plan?
A) Avoid using hand gestures when working with the client
B) Use therapeutic touch during conversation
C) Discourage the client from using a faith healer
D) Maintain direct eye contact when speaking with the client
Answer: B) Use therapeutic touch during conversation
15. A nurse is conducting an educational session at an assisted living facility for a group of
clients who have osteoporosis. Which of the following statements should the nurse include in
the teaching?
A) "It is important to avoid weight-bearing exercises."
B) "Decrease your dietary intake of folate."
C) "Increase your daily intake of leafy green vegetables."
D) "It is important to spend 30 minutes each day exposed to sunlight."
Answer: C) "Increase your daily intake of leafy green vegetables."

16. A hospice nurse is teaching about expected grief reactions with the family of a client who
has end-stage pancreatic cancer. Which of the following information should the nurse
include?
A) "It is common to experience a persistent state of sadness while grieving."
B) "Disturbances in your self-esteem is an expected grief reaction."
C) "You will feel a sense of hopelessness throughout the grieving process."
D) "A component of healthy grieving is the ability to openly express your anger."
Answer: D) "A component of healthy grieving is the ability to openly express your anger."
17. A nurse is preparing an educational program about influenza for a group of community
health nurses. Which of the following activities should the nurse include as an example of
tertiary prevention?
A) Offer classes to elementary school teachers about handwashing
B) Provide info to occupational nurses about the reasons for employees to not come to work
C) Administer antiviral medications within 48 hours to clients who have manifestations of
influenza
D) Provide immunizations at long-term care facilities
Answer: C) Administer antiviral medications within 48 hours to clients who have
manifestations of influenza
18. An occupational health nurse is planning to use an interpreter during an educational
session with a group of migrant workers who do not speak the same language as the nurse.
Which of the following actions should the nurse take? (Select all that apply)
A) Instruct the interpreter to guide the nurse in providing information in a culturally-sensitive
manner
B) Ask the interpreter to add information she feels may be necessary
C) Choose an interpreter who speaks the workers' language and dialect
D) Evaluate the interpreter's approach to clients prior to the educational session
E) Encourage the interpreter to paraphrase the workers' questions and responses
Answer: C) Choose an interpreter who speaks the workers' language and dialect
19. A nurse in a rural health clinic is caring for a client who has heart failure. The client
states, "I'm not going to take any more heart medicine." Which of the following responses
should the nurse make?

A) "Why did you decide to stop your heart medicine?"
B) "Can you tell me more about your decision to stop your medicine?"
C) "Don't you know what stopping your medicine will do to your heart?"
D) "Don't you think your doctor knows what's best for your heart?"
Answer: B) "Can you tell me more about your decision to stop your medicine?"
20. A community health nurse is planning an educational program for farmers about
occupational health risks. Which of the following risks should the nurse include?
A) Respiratory disorders
B) Diabetes mellitus
C) Sickle cell anemia
D) Hypertension
Answer: A) Respiratory disorders
21. A community health nurse is working to meet the health care needs of residents in a rural
community. Which of the following characteristics should the nurse identify as a barrier to
health care resources for this population?
A) Less autonomy in providing client care
B) Disinterest by members of the population in providing input for community health
programs
C) Lack of cohesiveness among community members
D) Unavailability of outreach services
Answer: D) Unavailability of outreach services
22. A community health nurse is teaching a client who is overweight about steps to take to
begin an exercise program. The nurse should identify that which of the following statements
is an indication that the client understands the teaching?
A) "I will need to purchase exercise equipment before I can start."
B) "I should try to perform aerobic exercises for 1 hour/day, 5 days a week."
C) "I will see my doctor before beginning an exercise program."
D) "I should avoid participating in weight-lifting exercises."
Answer: C) "I will see my doctor before beginning an exercise program."

23. A public health nurse is participating in a community planning committee for disaster
preparedness for a local community that is at risk for hurricanes. Which of the following
information should the nurse contribute to the plan?
A) A list of residents who have experienced a hurricane in the past and will not need
evacuation
B) A list of areas within the community where residents speak English as a second language
C) How to activate the local medical facility's emergency-management plan
D) The name of the individual who is necessary to implement the plan
Answer: B) A list of areas within the community where residents speak English as a second
language
24. A nurse is providing blood pressure screenings for older adult clients at a local
community center. Which of the following should the nurse identify as increasing a client's
risk for developing hypertension (HTN)?
A) BMI of less than 30
B) Daily walking routine
C) African American race
D) HDL level greater than 70 mg/dL
Answer: C) African American race
25. A home health nurse is planning care for the day. Which of the following clients should
the nurse visit first?
A) An older adult client who was treated in the emergency department last night for a stage
III pressure ulcer
B) A school-age child who was treated in the emergency department last night with status
asthmaticus
C) An older adult client who has a newly prescribed antihypertensive medication and needs a
blood pressure check
D) A school-age child whose percutaneous endoscopic gastrostomy (PEG) tube needs
changing
Answer: B) A school-age child who was treated in the emergency department last night with
status asthmaticus

26. A community health nurse is working in a mobile health care clinic. Which of the
following clients should the nurse assess first?
A) A client who requires removal of sutures from a laceration
B) A client who has a temperature of 37.8 C (100.1 F)
C) A client who has COPD and an oxygen saturation of 92%
D) A client who has a new onset of confusion and slurred speech
Answer: D) A client who has a new onset of confusion and slurred speech
27. A nurse in a community center is preparing to administer a tuberculin skin test to multiple
clients to screen for TB. Which of the following actions should the nurse take?
A) Prepare the outer aspect of the upper arm for the injection
B) Insert the needle at a 45-degree angle
C) Inject 0.1 mL of purified protein derivative
D) Create a wheal that measures about 15 mm in diameter
Answer: C) Inject 0.1 mL of purified protein derivative
28. A public health nurse is monitoring medication compliance for a group of migrant
workers who are being treated for TB. The nurse should use information from which of the
following resources to assist with this process?
A) Agency for Healthcare Quality and Research (AHRQ)
B) Migrant Clinicians Network (MCN)
C) Centers for Disease Control and Prevention (CDC)
D) U.S. Preventive Services Task Force (USPSTF)
Answer: B) Migrant Clinicians Network (MCN)
29. A school nurse is conducting visual acuity testing for a school-age child. Which of the
following actions should the nurse take?
A) Allow the child to keep her glasses on during the test
B) Have the child stand 5 ft away from the Snellen letter chart
C) Progress to the next line once the child reads 2 symbols correctly
D) Begin the test by instructing the child to use both eyes to read the chart
Answer: A) Allow the child to keep her glasses on during the test

30. A public health nurse is developing a visual health program by using a communityoriented approach. Which of the following interventions should the nurse include?
A) Teach a client who has vision loss about safety in the home environment
B) Provide genetic counseling to the family of a newborn who has congenital cataracts
C) Consult with the local school nurse to schedule yearly vision screenings for students
D) Develop a plan of care for a client who was newly diagnosed with glaucoma
Answer: C) Consult with the local school nurse to schedule yearly vision screenings for
students
31. A public health nurse is planning care for 4 clients. Which of the following interventions
should the nurse recognize as tertiary prevention?
A) Providing chemoprophylaxis for malaria to a client who is traveling to mosquito-infested
countries
B) Performing a serological screening for HIV for a client who is pregnant
C) Participating in partner notification for a client who has an STI
D) Administering antibiotics to a client who has AIDS and was diagnosed with Pneumocystis
jiroveci
Answer: D) Administering antibiotics to a client who has AIDS and was diagnosed with
Pneumocystis jiroveci
32. A nurse in a county health department is caring for a client who states, "I've been drinking
too much in the evenings since my mom died last year." Which of the following responses
should the nurse make?
A) "It sounds like you are probably an alcoholic."
B) "Don't you think your family is being affected by your drinking?"
C) "Can I give you some info about AA?"
D) "I don't think your mom would have approved of your drinking."
Answer: C) "Can I give you some info about AA?"
33. A public health nurse is developing a presentation for local day care providers about
infectious childhood diseases. Which of the following statements should the nurse include?
A) "Respiratory syncytial virus is spread through contact with respiratory secretions from an
infected person."
B) "Rotavirus infections in children peak during the summer months."

C) "Children who have fifth disease will exhibit bloody diarrhea."
D) "Antiviral medications shorten the duration of a shigella infection."
Answer: A) "Respiratory syncytial virus is spread through contact with respiratory secretions
from an infected person."
34. A community health nurse suspects an outbreak of scabies in the local area. Which of the
following actions should the nurse take first?
A) Educate the community about disease transmission
B) Determine the incidence rate
C) Institute prophylactic treatment
D) Discuss treatment plans with the clients' families
Answer: B) Determine the incidence rate
35. A community health nurse is discussing the concept of epidemiology with a coworker.
Which of the following interventions should the nurse provide as an example of the use of the
principles of epidemiology?
A) Conducting screenings for dental caries in the local school system
B) Reviewing county health records for data on cases of chickenpox
C) Providing a client with information about preventing STIs
D) Documenting medication compliance for clients who have TB
Answer: B) Reviewing county health records for data on cases of chickenpox
36. A community health nurse is assigned to lead a county-level environmental task force.
Which of the following activities should the nurse direct the task force to complete first?
A) Review community-specific epidemiological data
B) Recommend updates to local environmental policies
C) Create program goals that align with Healthy People 2020 objectives
D) Distribute environmental health educational materials to community members
Answer: A) Review community-specific epidemiological data
37. A community health nurse is teaching a client who was newly diagnosed with active
pulmonary TB about disease transmission. Which of the following information should the
nurse include?
A) Household members should be placed in respiratory isolation

B) The client should use disposable utensils during meals
C) Household members should take isoniazid for 6-12 months
D) The client should have a repeat purified protein derivative test in 3 months
Answer: C) Household members should take isoniazid for 6-12 months
38. The daughter of a client who is terminally ill and at the end of life approaches a hospice
nurse and asks what she can do to help relieve her father's pain. Which of the following
interventions should the nurse suggest?
A) Give the client brief hand massages
B) Increase the illumination in the room
C) Place a warm cloth on the client's forehead
D) Administer citalopram when the client is agitated
Answer: A) Give the client brief hand massages
39. A community health nurse has been contacted regarding a client diagnosed with influenza
type A in an adult day care. Which of the following actions should the nurse take to assist in
the prevention of an outbreak?
A) Administer antiviral medication to clients at the facility to provide immediate protection
and to help prevent an outbreak
B) Schedule immunizations for clients at the facility
C) Recommend that the day care center close for 2 weeks
D) Give immune globulin to clients at the facility who have early manifestations of influenza
Answer: A) Administer antiviral medication to clients at the facility to provide immediate
protection and to help prevent an outbreak
40. A nurse in a rural community is planning education for a young adult client who is a
migrant farm worker. Which of the following actions should the nurse include? (SATA)
A) Provide environmental health information
B) Refer the client for a TB screening
C) Provide skin cancer information
D) Recommend a dental health screening
E) Provide forms to apply for Medicare
Answer: A) Provide environmental health information
B) Refer the client for a TB screening

C) Provide skin cancer information
D) Recommend a dental health screening
41. A public health nurse is working in a community that has a population of 24,096. There
are 2,096 existing cases of heart disease within the population. The nurse can determine
which of the following from this info?
A) Mortality rate
B) Attack rate
C) Prevalence proportion
D) Incidence proportion
Answer: C) Prevalence proportion
42. A home health nurse is assessing an older adult client who is taking captopril to treat heart
failure. Which of the following findings should the nurse identify as an adverse effect of this
medication?
A) Weight gain
B) Ataxia
C) Photophobia
D) Dry cough
Answer: D) Dry cough
43. A nurse is developing an educational program about bioterrorism and smallpox. The nurse
should include in the teaching that the smallpox rash is expected to first appear in which of
the following locations?
A) Face
B) Posterior shoulders
C) Abdomen
D) Lower extremities
Answer: A) Face
44. A nurse is assessing the risk and benefits of meal delivery services for an older adult
client who lives alone and has no transportation. Which of the following ethical principles is
the nurse demonstrating?
A) Distributive justice

B) Respect for autonomy
C) Fidelity
D) Beneficence - by determining if the client needs this service to maintain his health
Answer: D) Beneficence - by determining if the client needs this service to maintain his
health
45. A nurse is conducting a home visit with a female client who reports a history of intimate
partner abuse. The nurse should identify that which of the following findings places the client
at greatest risk for domestic violence?
A) The client is at 13 weeks of gestation
B) The client states she is leaving her partner
C) The client recently started a new job
D) The client visits friends without her partner's knowledge
Answer: B) The client states she is leaving her partner
46. A case manager is developing a discharge plan for a client who has a spinal cord injury
and is in a rehab facility. Which of the following actions should the nurse take first?
A) Hold a care conference with the client and his family to discuss treatment options
B) Contact service providers to determine the availability of services offered
C) Determine the client's ability to perform self-care
D) Evaluate the client's satisfaction with the case manager's services
Answer: C) Determine the client's ability to perform self-care
47. A nurse at a county health clinic is caring for a client who has recently assumed the role
of primary caregiver for her mother. Which of the following statements by the client indicates
that she is experiencing role conflict?
A) "I feel overwhelmed with not having enough time for my mom as well as my children."
B) "I hope my siblings will be able to visit and help care for mom for a few days."
C) "I am glad that my job is flexible, so I can accommodate my mom's needs."
D) "I don't think my partner likes having to help more with the household chores."
Answer: A) "I feel overwhelmed with not having enough time for my mom as well as my
children."

48. A nurse is planning to teach a community group about the meningococcal vaccine. The
nurse should identify that which of the following clients should receive the vaccine?
A) A client who is traveling to northern Europe
B) An infant who has bronchiolitis
C) An infant who is 4 weeks old
D) A client who is moving into a college dormitory
Answer: D) A client who is moving into a college dormitory
49. A public health nurse is providing information to a client who has alcohol use disorder
and is asking about treatment. Which of the following statements should the nurse identify as
an indication that the client understands the information?
A) "I will not have to completely stop drinking alcohol if I go into an inpatient treatment
program."
B) "Once I make it through detox, I will be free of my addiction."
C) "I am not eligible for an outpatient program until I have completed an inpatient program
first."
D) "I can expect to get help with other aspects of my life while in treatment."
Answer: D) "I can expect to get help with other aspects of my life while in treatment."
50. A nurse on the scene following a mass casualty explosion is triaging a client who has a
large, open occipital wound and the following findings: respiratory rate 6/min, agonal pattern;
cap refill time 4.5 secs; nonresponsive to painful stimuli. Which of the following actions
should the nurse take?
A) Turn the client to left semi-Fowler's position and begin assessing the next client
B) Place a firm pressure dressing to the occiput and open the airway
C) Apply a cervical spine collar and perform a focused neurological exam
D) Request that the client be assessed immediately by the next available provider
Answer: A) Turn the client to left semi-Fowler's position and begin assessing the next client

VERSION 8
ATI COMMUNITY HEALTH PROCTORED PRACTICE ASSESSMENT B2

1. A nurse who is facilitating a support group in a community center notices that one member
of the group expresses anger repeatedly. Which of the following strategies should the nurse
use to facilitate the group process with this member.
A) Remind the group that everyone should have a chance to participate.
B)Divide the group into pairs and give each pair a topic for discussion.
C) Give the member extra time to compose her thought before expressing them.
D) Focus more on the group members who have a positive outlook.
Answer: D) Focus more on the group members who have a positive outlook.
Rationale:
This is a strategy that is often effective with group members who demonstrate angry, hostel,
or negative behavior. The nurse should also speak to the group member in private to try to
uncover the source of her ongoing anger.
2. Which of the following activities done by a nurse is considered public health nursing?
A) Reviewing morbidity and mortality data for the community.
B) Caring for new mothers and infants.
C) Reviewing the medications prescribed for an older adult couple.
Answer: A) Reviewing morbidity and mortality data for the community.
Rationale:
Reviewing morbidity and mortality data for the community is a key component of public
health nursing, which focuses on the health care of populations and communities.
3. A nurse working for a non-profit organization with limited resources is asked to develop an
education program that will benefit a supporting agency's employees. The nurse was planning
another program to benefit more people in the community. Which of the following is an
ethical tenet the nurse should follow in deciding which program to implement.
A) Allow members of the community to vice their shared ideas.
B) Develop public policy in concert with the interest and needs of the community.
C) Give precedence to community support provided by public servants over entrepreneurs.
D) Place the needs of the community above those of special interest groups.
Answer: D) Place the needs of the community above those of special interest groups.
Rationale:
This statement upholds the ethical tenet for policy development: to serve citizens, not
customers. While the nurse may feel pressure to comply with the agency's request due to its

financial or material support, the nurse must use available resources to meet the needs of the
greatest number of citizens first.
4. A community health nurse is providing care to a client who has stopped taking his
prescribed blood pressure medication. Which of the following actions should the nurse take
first to promote adherence to treatment.
A) Inform the provider of the client's decision.
B) Determine the client's reason for discontinuing the medication.
C) Discuss the consequences of discontinuing the medication with the client.
Answer: B) Determine the client's reason for discontinuing the medication.
Rationale:
Using the nursing process, the first step the nurse should take is to assess the client. By
determining the client's reason for discontinuing the medication, the nurse can promote
adherence to treatment.
5. A clinic nurse is caring for a client who reports taking ginkgo biloba for several weeks
since seeing a naturapathic healer. The nurse should instruct the client that ginkgo biloba may
alter the effects of which of the following medications?
A) Warfarin
B) Metoprolol
C) Digoxin
Answer: A) Warfarin
Rationale:
Ginkgo biloba can hinder coagulation; therefore, the nurse should instruct the client that
ginkgo biloba may alter the effects of warfarin.
6. A community health nurse is preparing a community presentation about the
epidemiological triangle. Which of the following elements is a host.?
A) Salmonella on a wood cutting board.
B) A raccoon with rabies
C) A farm containing pesticides
D) a factory with high noise levels.
Answer: B) A raccoon with rabies
Rationale:

The epidemiological triangle is a model of the agent-host environment interaction that causes
disease. The host is a living species, either human or animal, that is capable of being infected
ore affected by an agent.
7. A community health nurse is providing anticipatory guidance to a group of adolescents. To
reduce premature deaths in this age group, which of the following topics would be most
important to discuss.
A) Underage smoking
B) Safe sex practices
C) Safety belt use
Answer: C) Safety belt use
Rationale:
Automobile crashes are currently the leading cause of death among adolescents; therefore,
this topic is important to discuss when providing anticipatory guidance to reduce premature
deaths in the age group.
8. A newly licensed nurse in a public health agency is assigned to assist with the task force
that is responsible for the core function of assessment. Which of the following is a task that
the nurse could be assigned that would be consistent with the focus of the task force?
A) Investigating local health hazards.
B) updating local policies to support community health efforts.
C) Collaborating with community agencies to improve availability of services.
Answer: A) Investigating local health hazards.
Rationale:
Investigating health hazards of the local community is a component of the public health core
function of assessment.
9. A community health nurse is visiting a family that has newborn twins and two school-age
children. The parents tell the nurse they are emotionally and financially overwhelmed. Which
of the following referrals are appropriate? (Select all that apply).
A) Postpartum support group
B) Women, Infant, and Children (WIC) program
C) Child Protective Service (CPS)
D) Medicare Part B

E) Free school lunch program.
Answer: A) Postpartum support group
B) Women, Infant, and Children (WIC) program
E) Free school lunch program.
10. A public health nurse is working in a community that has a population of 24.096. There
are 2.096 existing cases of heart disease within the population. The nurse can determine
which of the following from this information.
A) Mortality rate
B) Attack rate
C) Prevalence proportion
D) Incidence proportion.
Answer: C) Prevalence proportion
Rationale:
The prevalence proportion can be calculated given how many people were affected at a given
time and the total population.
11. A newly licensed nurse is performing a community assessment. While collecting
secondary data at the library, the nurse is approached by a community member who is
concerned about air pollution. Which of the following statements by the nurse indicates a
need for further education regarding confidentiality?
A) "Records indicate that several pesticides have been entering the local streams causing
significant water pollution."
B) According to the latest research, there is an infant mortality ratio of 6.7 per 1,000 live
births in this community.
C) The circulation supervisor at the library is concerned about the amount of air pollution
coming from the town's industrial corridor.
D) Residents near Cherry Street Substation have a mortality rate of 29.6% from brain tumors
compared to the citywide rate of 9.2%.
Answer: C) The circulation supervisor at the library is concerned about the amount of air
pollution coming from the town's industrial corridor.
Rationale:
The nurse has a responsibility to protect community members who share concerns or provide
controversial information.

12. A nurse is planning to teach a community group about the meningococcal vaccine. For
which of the following individuals is this vaccination recommended.
A) An individual traveling to northern Europe.
B) An infant who has bronchitis.
C) An infant who is 4 weeks old.
D) An individual moving into a dormitory setting.
Answer: D) An individual moving into a dormitory setting.
Rationale:
Individuals living in crowded areas such as dormitories should receive the meningococcal
vaccine.
13. A community health nurse is caring for a client who has a new diagnosis of Lyme disease.
The requirements for a reporting Lyme disease are mandated by which of the following?
A) Local county health departments
B) Individual state law
C) federal law
D) Center for disease control and prevention.
Answer: B) Individual state law
Rationale:
While Lyme disease is on the list of national diseases, the requirements and methods of
reporting individual diseases are determined by state laws.
14. A community health nurse is conducting an educational program for parents about the
effects of pollution on preschool-age children. Which of the following statements by a parent
indicates an understanding of the teaching?
A) Children drink fewer fluids for their body weight than adults, so they take in fewer toxins.
B) The kidneys filter toxins at a greater rate in children than in adults.
C) Children breathe more rapidly than adults, which increases their exposure to air pollutants.
D) Outdoor air pollutants are more likely to trigger asthma attacks than indoor pollutants.
Answer: C) Children breathe more rapidly than adults, which increases their exposure to air
pollutants.
Rationale:
Children breathe faster than adults, which increases their exposure to toxins in the air

15. A school nurse sees four students in 1 week who have a return-to-school release after
being diagnosed with methicillin-resistant Staphylococcus aureus(MRSA). Which of the
following actions should the nurse take
A) Coordinate an immunization clinic at the school.
B) Recommend prophylactic treatment for classmates.
C) Report the cases of MRSA to child protective services.
D) Provide education about MRSA throughout the school system.
Answer: D) Provide education about MRSA throughout the school system.
Rationale:
Hand hygiene will prevent the spread of MRSA.
16. A nurse in a rural community is planning education for a young-adult client who is a
migrant farm worker. Which of the following should the nurse include in the plan of care
(select all that apply).
A) Provide environmental health information.
B) Conduct tuberculosis screening
C) Provide skin cancer information
D) Conduct dental health screening.
E) Provide forms to apply for Medicare.
Answer: A) Provide environmental health information.
B) Conduct tuberculosis screening
C) Provide skin cancer information
D) Conduct dental health screening.
17. An occupational health nurse is assessing a client who reports taking ibuprofen daily for
several years. The nurse should counsel the client on the risk for which of the following
conditions?
A) Gastric ulceration
B) Orthostatic hypotension
C) Hyperglycemia
D) Urinary retention.
Answer: A) Gastric ulceration
Rationale:

Long term use of NSAIDs such as ibuprofen increases the risk of gastric ulceration,
perforation and hemorrhage.
18. A school health nurse is caring for an adolescent newly diagnosed with type 1 diabetes
mellitus. Which of the following actions is appropriate to include in the client's plan of care?
A) Consult with a dietitian to determine an appropriate school lunch for the client.
B) Encourage the client to have a snack 3 hours prior to physical activities.
C) Provide weekly updates on the clients condition to the insurance provider.
D) Obtain specimen to test for ketonuria daily.
Answer: A) Consult with a dietitian to determine an appropriate school lunch for the client.
Rationale:
This action assists the client in obtaining appropriate nutrition for the disease process.
19. A school nurse is helping a student schedule speech therapy and physical therapy
appointments that do not interfere with the student's academic schedule. This is an example
of which of the following roles of the school nurse?
A) Health educator
B) Case manager
C) Counselor
D) Consultant
Answer: B) Case manager
Rationale:
The nurse is coordinating the members of the interdisciplinary team to provide the health care
required by the student.
20. A nurse in a community health center is talking with the parent of an adolescent who is
concerned that her sons seems depressed and is giving away his favorite belongings. Which
of the following actions should the nurse take?
A) Tell the parent that it is common for adolescents to lose interest in their belongings.
B) Explain that what might seem like depression is probably typical teenage boredom.
C) Talk with the adolescent about trying to be more cooperative and appreciative.
D) Determine if the adolescent has considered harming himself.
Answer: Determine if the adolescent has considered harming himself.
Rationale:

Clues that should alert the nurse to suicidal intent include giving away possessions.
Depression is another risk factor for suicide.
21. A nurse is collecting demographic data as a part of a community assessment. Which of the
following should be included?
A) Racial distribution
B) Family genograms
C) Number of open water sources
D) Presence of condemned buildings.
Answer: A) Racial distribution
Rationale:
Racial distribution is part of demographic data.
22. A nurse is a clinic is planning teaching for a client who is newly diagnosed with hepatitis
C. Which of the following instructions should the nurse include in the teaching?
A) Consume a low carbohydrate diet until symptoms resolve.
B) Schedule an appointment for an immunoglobulin injection.
C) Abstain from sexual intercourse until antibody tests are negative.
D) Wear a mask in public places while receiving treatment.
Answer: C) Abstain from sexual intercourse until antibody tests are negative.
Rationale:
Hepatitis C is transmitted through sexual intercourse; therefore, the nurse should instruct the
client to abstain from sexual intercourse until antibody tests are negative.
23. A home health nurse is caring for an older adult client who has diabetes mellitus
complicated by severe peripheral neuropathy. Which of the following instructions should the
nurse provide the client to avoid injury to the feet and lower legs? (select all that apply)
A) Test bath water with a thermometer before entering.
B) Wear shoes that extend 0.64 cm past the longest toe.
C) Use a dry heating pad to enhance circulation in feet.
D) Inspect feet for areas of redness daily.
E) Monitor temperature of feet and lower extremities for changes.
Answer: A) Test bath water with a thermometer before entering.
D) Inspect feet for areas of redness daily.

E) Monitor temperature of feet and lower extremities for changes.
24. A community health nurse is planning an in-service about sexually transmitted infections
to a group of adolescents. Which of the following clinical findings should the nurse include
as a manifestation of primary syphilis?
A) Malaise
B) Maculopapular rash on palms
C) Chancre
D) Lyomphadenopathy.
Answer: C) Chancre
Rationale:
Chancre is a clinical manifestation of primary syphilis.
25. A hospice nurse is caring for a client who is at the end of life and has developed dyspnea
and noisy breathing. Which of the following actions should the nurse take?
A) Suction the client's oropharynx.
B) Encourage the client to take sips of water frequently.
C) Use a fan in the client's room.
D) Offer small portions of the clients favorite foods.
Answer: C) Use a fan in the client's room.
Rationale:
A fan moves the air, which stimulates the client's trigeminal nerve and can minimize the
sensation of dyspnea.
26. A nurse at a rehabilitation facility is providing discharge teaching for a client who is
recovering from a stroke. Which of the following statements should the nurse include.
A) Your family should provide the majority of your care to ensure that your needs are met.
B) You should contact outpatient therapy to schedule an admission assessment within two
weeks.
C) You should use a hand-held mirror to improve your ability to see objects around you.
D) You should focus on dressing and caring for the unaffected side of your body first.
Answer: C) You should use a hand-held mirror to improve your ability to see objects around
you.
Rationale:

Clients who experience a stroke may experience altered visual perception and decreased
visual fields; therefore, the nurse should recommend that clients use a hand-held mirror to
improve the ability see objects in the surrounding environment.
27. A nurse manger is providing orientation to a nurse who is new to hospice care. Which of
the following statements indicates that the new nurse needs additional orientation.
A) I will link clients with services that assist them to continue living at home.
B) I will modify client's treatment plan as needed to maximize his independence level.
C) I will provide care and education to clients in order to promote recovery.
D) I will work as team to alleviate symptoms and meet the client's special needs.
Answer: C) I will provide care and education to clients in order to promote recovery.
Rationale:
The goal of hospice is to deliver palliative care and emotional support to clients who are no
longer seeking curative treatment for an illness.
28. A nurse in a community health center is talking with a client who is receiving treatment
for an opioid addiction. Which of the following statements by the nurse is appropriate for
encouraging the client to attend his 12-step meeting?
A) You'll find the Narcotics Anonymous will help you regain power over your addictions.
B) Narcotics Anonymous will help you take responsibility for the symptoms of you disease.
C) At Narcotics Anonymous you willingness to change will be crucial for your sobriety.
D) At Narcotic Anonymous you'll learn to maintain control by never admitting to defeat.
Answer: C) At Narcotics Anonymous you willingness to change will be crucial for your
sobriety.
Rationale:
Basic tenets of all 12-step programs, including Narcotics Anonymous, have a willingness to
change and to make amends, as well as the incorporation of the 12-step process into daily
life.
29. A community health nurse is asked to give a health education program to a group of
African-American men age 40 to 75. Considering the health concerns of this group, which of
the following topics is most important to include in the program?
A) Prostate cancer screening.
B) Diabetes screening.

C) Depression screening.
D) Skin cancer screening.
Answer: A) Prostate cancer screening.
Rationale:
Cancer is the second leading cause of death for men and prostate cancer is the second leading
cause of cancer deaths in men. The incidence rate of prostate cancer is 51% higher among
African-American men than white men.
30. A clinical nurse manager is developing an education program on tuberculin skin testing.
The nurse should include that which of the following can cause a false negative result?
(Select all that apply).
A) Advanced HIV or AIDS.
B) Bacilli Calmette-Gue'rin (BCG) vaccination.
C) Time between exposure and screening.
D) Age of the client.
E) Recent abuse of IV-substance.
Answer: A) Advanced HIV or AIDS.
C) Time between exposure and screening.
D) Age of the client.
31. A nurse is planning health promotion activities for the local community. Which of the
following is an example of primary prevention.
A) Teaching foot care to adults who have diabetes mellitus.
B) Testing school-age children for lead exposure.
C) Providing tuberculosis screening for day care providers.
D) Teaching meal planning classes to older adults.
Answer: D) Teaching meal planning classes to older adults.
Rationale:
This is an example of primary prevention.
32. A nurse is caring for a client who has AIDS and is experiencing rapid weight loss. Which
of the following action should the nurse take first.
A) Examine the client's oral mucous membranes.
B) Encourage the client to consume 1.2 to 2.0 g/kg of protein daily.

C) Recommend the client increase daily calorie intake by 25%.
D) Teach the client about findings that should be reported to the provider.
Answer: A) Examine the client's oral mucous membranes.
Rationale:
The first action the nurse should take using the nursing process is to assess the client. The
nurse should examine the oral mucous membranes for painful lesions, such as candidiasis,
that result from HIV or HIV therapy.
33. A nurse is caring for a 50 year old client who has diabetes mellitus, recently lost his job,
and has no health insurance. The nurse should advise the client to do which of the following?
A) Contact Medicare to determine eligibility.
B) Contact Medicaid to determine eligibility.
C) Go to the emergency department when services are needed.
D) Go to the public health department when services are needed.
Answer: B) Contact Medicaid to determine eligibility.
Rationale:
Medicaid is available to individuals with low income and no insurance. Eligibility and
resources vary by state, so the client should contact the local office to determine his status.
34. A home health nurse is assessing a client who has a prescription for captopril to treat heart
failure. Which of the following findings is an adverse effect of this medication.
A) Weight gain
B) Ataxia
C) Photophobia
D) Dry cough
Answer: D) Dry cough
Rationale:
Captopril prevents the conversion of angiotensin 1 to angiotensin 2 which causes bradykinin
to accumulate. The client may experience cough as a result of bradykinin accumulation.
35. A community health nurse is providing education to a group of children who have asthma.
Which of the following statements indicates an understanding of the teaching.
A) I shouldn't play sports because it will make me too tired.
B) I will stay indoors during cold weather.

C) I will use my rescue medication every day.
D) I shouldn't get the flu shot because it might make me sick.
Answer: B) I will stay indoors during cold weather.
Rationale:
Cold air can be trigger for asthma. This response indicates the student recognizes the risk.
36. A client asks a home health infusion nurse the difference between a peripheral IV line and
Peripherally inserted central catheter (PICC) for long-term venous access. Which of the
following responses is appropriate?
A) Blockages do not form in central catheters like they do in peripheral catheters.
B) There won't be any infections in your arm from the central catheter.
C) The central catheter does not require flushing like the peripheral catheter.
D) The central catheter does not require replacement as often as a peripheral IV
Answer: D) The central catheter does not require replacement as often as a peripheral IV
Rationale:
Nurses must replace peripheral IV catheters every 72 to 96 hours, while a PICC may remain
in place for a year or more, as long as there are no complications with the insertion site or the
catheter.
37. The daughter of a client who is terminally ill and at the end of life approaches the hospice
nurse and asks what she can do to help relieve her father's anxiety. Which of the following
interventions should the nurse suggest?
A) Give the client brief hand massages.
B) Increase the illumination in the room.
C) Place a warm cloth on the clients forehead.
D) Administer citalopram when the client is agitated.
Answer: A) Give the client brief hand massages.
Rationale:
Soft massage and brief hand massage can reduce stress in palliative care settings.
38. A community health nurse is teaching a group of older adults about environmental health
hazards. A need for additional teaching is indicated when a group member lists which of the
following as a possible source of carbon monoxide exposure.
A) Motor vehicles

B) Gas ranges
C) Vented gas heaters
D) Electric space heaters.
Answer: D) Electric space heaters.
Rationale:
Electric space heaters are not a source of carbon monoxide poisoning.
39. A community health nurse is planning a presentation to aging adults who have a family
history of Alzheimer's disease. The nurse should include that which of the following
behaviors is an early manifestation of the disease.
A) Withdrawal form social activities
B) Difficulty learning new things
C) Loss of language skills
D) Neglecting personal hygiene.
Answer: B) Difficulty learning new things
Rationale:
Difficulty learning new things is generally an early indication of Alzheimer's disease. Other
early indicators include short-term memory loss and subtle changes in personality.
40. A home health nurse is planning care for the day. Which of the following clients should
the nurse visit first.?
A) An older adult client who was treated in the emergency department last night with a stage
3 pressure ulcer.
B) A school-age child who was treated in the emergency department last night with status
asthmaticus.
C) An older adult client on a newly prescribed antihypertensive who needs a blood pressure
check.
D) A school-age child whose percutaneous endoscopic gastrostomy (PEG) tube needs
changing.
Answer: B) A school-age child who was treated in the emergency department last night with
status asthmaticus.
41. A nurse is providing safety information to the parents of an infant. Which of the following
statement by a parent indicates the need for further teaching.

A) It important to keep our bathroom doors closed.
B) The slats on our child's crib are 2 inches apart.
C) I will make sure the water heater setting is no higher than 140 degrees F.
D) I will clip a pacifier onto my child's clothing during naps.
Answer: C) I will make sure the water heater setting is no higher than 140 degrees F.
Rationale:
The water heater should be at a setting no higher than 120 degrees F to prevent accidental
burns.
42. A school nurse is notified that an elementary school child is newly diagnosed with
pertussis. Which of the following actions should the school nurse take? (select all that apply).
A) Instruct the parent to keep the child home until the coughing stage has passed.
B) Encourage family members to obtain prophylactic treatment.
C) Quarantine the children in the child's class.
D) Recommend the child receive a pneumococcal vaccine in 28 days.
E) Check the immunization status of child's classmates.
Answer: A) Instruct the parent to keep the child home until the coughing stage has passed.
B) Encourage family members to obtain prophylactic treatment.
E) Check the immunization status of child's classmates.
43. Community leaders have requested a meeting with a community health nurse to discuss
creating a mobile meals program. Which of the following should the community health nurse
assess first?
A) The need for the program.
B) The accessibility of residences.
C) The availability of volunteers.
D) The leadership of the community.
Answer: A) The need for the program.
Rationale:
Using the urgent vs. non-urgent approach to client care, the nurse should first assess the need
for the mobile meals program. This action allows the nurse to collect data on the client, which
is the community, and meets the first step of program planning. The needs of the community
will determine all other steps of the planning process.

44. A public health nurse is providing an educational program about inhalation anthrax to a
group of first responders in the community. Which of the following statements by a member
of the group indicates an understanding of the teaching?
A) Inhalation anthrax is highly contagious.
B) A person exposed to inhalation anthrax may develop a dry cough.
C) The drug of choice to treat inhalation anthrax is ciprofloxacin.
D) The fatality rate for untreated inhalation anthrax is about 65%.
Answer: B) A person exposed to inhalation anthrax may develop a dry cough.
Rationale:
Early clinical manifestation of inhalation anthrax include fever, fatigue, mild chest pain, and
a dry cough.
45. A nurse is providing education regarding lead exposure to a group of clients who live in a
subsidized housing development built in 1968. Which of the following silent statements
indicates an understanding of the teaching?
A) I will use a dry sanding technique when preparing to repaint my front door.
B) I will vacuum our wood floors every week.
C) I will increase the amount of red meat and milk in my child's diet.
D) I will use hot tap water when preparing my baby's formula.
Answer: C) I will increase the amount of red meat and milk in my child's diet.
Rationale:
Children should get adequate amounts of iron and calcium in their diets in order to prevent
lead absorption from their environment.
46. A nurse is preparing a community education program about health care needs during
pregnancy. The nurse should include that which of the following vaccines is safe to
administer to a client who is pregnant?
A) Herpes zoster
B) Tetanus, diphtheria, pertussis.
C) Varicella
D) Measles, mumps, rebells
Answer: B) Tetanus, diphtheria, pertussis.
Rationale:
The center for disease control and prevention recommends this vaccine during pregnancy.

47. A nurse is developing a community education program about risk factors for family
violence. The nurse should include which of the following circumstances as a risk factor for
becoming a victim of intimate partner abuse.
A) Attempting to end the relationship with their partner.
B) Lacking supportive friends outside the relationship.
C) Having health issues that limit independence.
D) Taking anti-anxiety or sedative medication.
Answer: A) Attempting to end the relationship with their partner.
Rationale:
Those in a relationship with a potential or actual abuser heighten their risk for abuse when
they attempt to leave the relationship.
48. A community health nurse has conducted a teaching session about breast selfexamination. Which of the following best indicates whether or not the teaching was
effective?
A) Completion of a written quiz.
B) Verbalization of the steps in the process.
C) Demonstration on a breast model.
D) Self-evaluation of the teaching session.
Answer: C) Demonstration on a breast model.
Rationale:
is the best indicator of teaching effectiveness when teaching a psychomotor skill.
49. A home health nurse is talking with a client whose partner died 3 months ago. The client
states " I still can't believe my partner is gone sometimes." Which of the following is an
appropriate nursing response.
A) Many people experience these feelings while grieving for a lost loved one.
B) Just give yourself some more time, and you'll feel better
C) Tell me more about how you're feeling.
D) I will schedule an appointment for you with the leader of your church.
Answer: C) Tell me more about how you're feeling.
Rationale:
The nurse should encourage the client to share her feelings about her life without her partner.

50. A home health nurse is orienting a newly licensed nurse who is drawing blood from a
client for laboratory testing and gets stuck by used needle. Which of the following statements
by the newly licensed nurse indicates a need for further teaching.
A) The client will be tested for HIV.
B) The client will be tested for hepatitis B virus.
C) The client will be tested for hepatitis C virus.
D) The client will be tested for hepatitis A virus.
Answer: D) The client will be tested for hepatitis A virus.
Rationale:
The client would not be tested for hepatitis A because it is primarily transmitted by the oralfecal route.

VERSION 9
ATI COMMUNITY NURSING PROCTORED STUDY GUIDE
Community Health nursing Theories:
• Nightingale’s Theory of Environment Health Belief Model
○ Focus on impact of a person’s environment on their health. Focus is on
preventative care (washing hands, clean environment)
• Health Belief Model
○ Assumes a person’s primary motivation in taking positive health actions
is to avoid getting a disease
• Likelihood of taking action is based on:
1. Modifying variables (age, gender, race, economy, education)
2. Perceived severity and susceptibility of getting the disease
3. Perceived benefits vs barriers of taking action
4. Cues to action (advice of doctor, media campaigns)
Community based nursing vs. community oriented nursing:
The community or population us the “client” in community health nursing
• Community based nursing- is focused on illness care (acute or chronic
conditions) for individuals and families.

Examples: home health nurse doing would care, school
nurse administering epi-pen
• Community oriented nursing: is focused on improving collective health of the
community.
Examples: health education and promotion, disease prevention
activities. No illness care! Community oriented nursing = public
health nursing
Community Health nursing vs. public health nursing
• Community health nursing: delivers health care services to individuals,
families, and groups. Includes community based nursing (illness care for
individuals and families) AND community oriented nursing (community
focused care, with emphasis on education and disease prevention)
• Public health nursing: disease prevention and health promotion of
communities and populations. They are not providing direct care to
individuals! Public health nursing = community oriented nursing.
Ethical Principles in Community Health nursing
- Respect for autonomy: respect a patient’s right to self determination
- Nonmaleficence: do no harm
- Beneficence: do what is best (maximize benefits)
- Distributive justice: fail allocation of resources in community
Epidemiology
- Study of spread, transmission, and incidence of disease/ injury
Components:
- Agent: what is causing the disease (bacteria, toxin, noise)
- Host: human/ animal being affected by the disease
- Environment: physical environment (water/ food supply, geography), social
experiment (access to health care, work conditions, poverty)
Incidence vs prevalence
Incidence: number of NEW cases of disease/ injury in a population during a specified
period of time
Prevalence: Number of ALL cases (new and preexisting) of disease/ injury in a
population during a specified period of time Community Health Education:
• Obstacles: age, culture, illiteracy, language barriers lack of access, lack of motivation
• Learning styles:

○ Visual (videos, presentations) o Auditory (verbal lectures, discussions)
○ Tactile- kinaesthetic (hands on, return demonstration)
• Healthy people 2020: Includes national health goals based on major risks to health and
wellness of U.S. population (ex. Diabetes, cancer, older adults, LGBT health).
Primary vs. Secondary vs. Tertiary prevention:
• Primary: prevents initial occurrence of disease
○ Ex. Education, immunizations, prenatal classes
• Secondary: focuses on early detection of disease, limiting severity of disease
○ Ex. Screenings, disease surveillance, control of outbreaks
• Tertiary: Maximize recovery after an injury/ illness
○ Ex. Rehabilitation, PT/OT, support groups
Acculturation, ethnocentrism, cultural assessment, interpreter
• Acculturation: adopting the traits of a different culture
• Ethnocentrism: the belief that one’s own culture is superior to all others. View world
from their own cultural viewpoint.
• Cultural Assessment: ask about patient’s ethnic background, religious preference,
family structure, food patterns and health practices. Incorporate patient preferences
into care whenever possible.
• Interpreter: use of family members is not recommended, interpreters need to have
knowledge of health terminology. Patient teaching materials should be available in
their primary language.
Environmental Risks/ Environmental Assessment:
• Environmental Risks:
○ Toxins (ex. Lead, pesticides, asbestos, radon)
○ Air pollution (ex. Carbon monoxide, tobacco smoke, lead)
○ Water pollution (ex. Waste products, chemical runoff from soil)
• Environmental assessment questions:
○ Condition of housing. Remodelling activities?
○ Water heater temperature less than 120 degrees F?
○ Occupation (including exposure to chemicals, toxins)?
○ Tobacco smoke present in home? o Quality of drinking water?
Lead exposure key points
• Pre 1978 housing at risk for lead based paint!
• Screen child 6 months- 5 years for blood lead levels

• Avoid playing in soil right outside home
• Wet mop floors (vs. vacuuming floors)
• Use wet sanding technique (vs. dry sanding)
• Make sure children get enough iron and calcium diet, as this decreases absorption of
lead in the body
• Use cold water (vs. hot water) because lead dissolves more quickly in hot water
Medicare and Medicaid
• Medicare eligibility:
○ Older than 65
○ Receiving disability for at least 2 years
○ Diagnosed with amyotrophic lateral sclerosis (ALS) or end stage renal
disease (ESRD) and receiving dialysis
• Part A: inpatient hospital, limited SNF, home health care
• Part B: outpatient care, diagnostic services, PT/OT
• Part C: combines Part A and Part B provided through private insurance
• Part D: prescription drug coverage (D is for Drug)
• Medicaid Eligibility: those with low socioeconomic status and no other insurance,
based on household size and income
State Department of Health, stage board of nursing, local health department
• State department of health: manages WIC program, CHIP, Medicaid program. Reports
notifiable communicable diseases to CDC (voluntary)
• State board of nursing: license LPNs and RNs, oversees state schools of nursing,
develops state’s nurse practice act
• Local health department: meets health needs of community. Reports notifiable
communicable diseases to state department of health
Community Assessment
• People:
○ Demographics
○ Biological factors (race, age, gender, health/ disease status) o Social factors
(education, income, crime rate) o Cultural factors (history, religion,
customs)
• Environment:
○ Physical factors (geography, housing, location of health care services)
○ Environmental factors (climate, pollutants, topography)

Types of Data collection in community nursing
• Informants interviews: direct conversations with member of community
• Community forum: public meeting (participation challenges)
• Secondary data: review existing data available (statistics, health records)
• Participant observation: observe community activities
• Windshield survey: literally drive through community and make observations
• Focus groups: meet with representative sample of community
• Surveys: written format (expensive, low response rate)
Windshield Survey
• People: general appearance, ethnicity/race of community members. Signs of violence?
Mental illness? Drug abuse?
• Place: quality of housing, access to health care facilities, types and availability of
grocery stores, public transportation, presence of schools, parks, and churches
Steps in developing and managing a community health plan
• Pre planning: brainstorm ideas
• Assessment: data collection
• Diagnosis: analyze collected data to determine health needs of the community. Set
priorities.
• Planning: Plan interventions. Establish goals, identify responsibilities, develop budget.
• Implementation: execute plan
• Evaluation: determine effectiveness of intervention Home Health Nurse
• Provides health care in patient’s homes and assisted living facilities (including nursing
homes)
• Provides patient education, direct nursing care, and care coordination (including
referrals)
• Assesses home for safety. Key items to look for: NO scatter rugs (carpet ok), no clutter,
adequate lighting on stairs (use of colored tape on step edges is helpful). For
Alzheimer’s patients, locks/ alarms on exit doors are appropriate.
Hospice nurses, parish nurses
• Hospice nurse: provides palliative care (focus on symptom management, not curing
disease), supports patient and family with dying process.
• Parish nurse: works w/ pastoral stall to improve the health and wellness of the faith
community Provides health education and facilitates support groups. Does NOT do
bedside nursing tasks.

Occupational Health Nurse
• Promotes health and wellness of employees, prevents workplace illness and injury
• Through surveillance, identifies risks within work environment. Identifies ways to
decrease or eliminate workplace hazards.
Keeps informed about OSHA standards.
• Primary prevention: provides safety education
• Secondary prevention: performs screenings
• Tertiary Prevention: sets up limited duty programs School Nurse
• Provides direct nursing care to children at school
• Provides health education
• Case manager for children w/ health needs (makes referrals, schedules appointments,
coordinates services)
• Primary prevention: assesses immunization status of children
• Secondary prevention: provides vison and hearing screening, screens for oral health,
scoliosis, infestations. Assesses for child abuse/neglect.
• Tertiary prevention: Administers medications, provides nursing care for children with
chronic diseases, assesses children with disabilities.
Key Health Concerns for:
Infants/Children: SIDS (sleep on back), injuries (wear helmets and seat belts),
communicable diseases (get immunizations)
Adolescents: motor vehicle accidents (wear seatbelts), substance abuse
(including smoking), safe sex, mental health
Women: menopause, osteoporosis, (encourage weight bearing exercise), heart disease,
diabetes, cancer prevention (get mammograms, pap smears)
Men: heart disease, cancer prevention, (get prostate cancer screening, testicular self-exams),
lung disease, liver disease
Older Adults: heart disease, CVAs, COPD, pneumonia, polypharmacy, cancer, injury
prevention (including falls)
Transitions, genograms, ecomaps
• Transitions: includes birth or adoption of child, death in family, major illness, divorce,
loss of income, etc.
○ Transitions = time of risk for family
• Genograms: graphical representation of relationships within the family, patterns of
illness (i.e. “enhanced” family tree)

• Ecomaps: graphical representation of family interaction with outside groups/
organizations which provides information about the family’s support network
Types of violence
• Homicide: often related to drug abuse, usually victim is someone know to perpetrator.
Males at higher risk.
Rape: Intimate partner violence very common; often unreported.
• Suicide: Highest in men, and those over 65 year old.
• Abuse: physical abuse, sexual abuse, emotional abuse (humiliation, intimidation),
neglect (failure to provide food, shelter, emotional care, medical care, education),
economic abuse (misuse of money, failure to provide for needs of victim despite
adequate funds, theft).
Violence, Child abuse
• Community factors that increase risk of violence: Unemployment, poverty, social
isolation. Child abuse is more common when spousal abuse is present.
• Signs of child abuse: presence of wounds or injuries in various states of healing,
unexplained bruises/ injuries, unusual fear of others. Small round burns that could be
caused by cigarettes, forearm spiral fractures
• Signs of child neglect: poor hygiene, inappropriate dress (for weather), signs of
malnourishment, withdrawal, school absences
Alcohol Abuse
• Factors that affect alcohol metabolism: size/ weight of drinker, time elapsed while
drinking, gender, presence of food in stomach
• Alcohol withdrawal: manifestations appear within 4-12 hours. Symptoms include:
tachycardia, hypertension, n/v, headache, anxiety/ irritability, diaphoresis, tremors,
seizures. It is important to ask patient when their last drink was!
• Primary prevention: public education campaigns, school education
• Secondary prevention: screen individuals for signs of abuse
• Tertiary prevention: refer patients to AA or NA, promote coping and lifestyle changes
Homelessness, Veterans
• Homelessness:
○ Fast growing segment: families with children
○ Risk factors: unemployment, migrant workers, veterans, mental illness,
substance abuse, HIV/AIDS, at risk youth

○ Key health issues: tuberculosis, infestations (scabies/ lice), substance abuse,
HIV/AIDS, mental illness
• Key health issues of veterans: mental health issues (PTSD, depression), substance
abuse, suicide, traumatic brain injury, spinal cord injury, amputations
Migrant workers
• Key health risks: tuberculosis, dental disease, skin cancer, diabetes, obesity, high risk
suicide, increased work related injuries (exposure to pesticides, injuries from
machinery)
• Primary prevention: education on reducing exposure to pesticides, accident prevention.
Preventative care (immunizations, dental care)
• Secondary prevention: screen for skin cancer, pesticide exposure, communicable
diseases
• Tertiary prevention: provide ER or primary care services, including treatment of
symptoms of pesticide exposure
Communicable Diseases: Modes of Transmission
• Airborne: chickenpox, measles, tuberculosis, pertussis, influenza
• Foodborne: salmonella, hepatitis A (fecal oral route), E-Coli, botulism
• Waterborne: cholera, typhoid fever
• Vector- borne: (ex. Mosquito or tick) lyme disease, malaria, rocky mountain spotted
fever
• Sexually transmitted: HIV, Hep B/C/D, syphilis, HPV, gonorrhea
• Direct contact: lice, scabies, impetigo
• Saliva: mononucleosis Types of Immunity
• Herd immunity: most community members have immunity, protecting those who can’t
(or choose not to get) immunized. Makes exposure unlikely.
• Active natural immunity: body produces antibodies in response to exposure to live
pathogen
• Active artificial immunity: body produces antibodies in response to vaccine
• Passive natural immunity: antibodies are passed form the mom to her baby thought the
placenta or breast milk
• Passive artificial immunity: Immunoglobulins are administered to an individual after
they have been exposed to a pathogen
Communicable Diseases: reporting, prevention

• Communicable disease reporting is mandated by state and local regulations. State
notification to CDC is voluntary.
• Primary prevention: provide education re: immunization, hand hygiene, proper food
handling, risk of infectious diseases when traveling to other countries (including
Hepatitis A)
• Secondary Prevention: provide screening, quarantine patients when needed, refer
suspected cases for definitive diagnosis
Tertiary prevention: monitor treatment compliance (may require direct observation
therapy)
Nationally Notifiable Diseases
• Lyme disease: key symptom is red bullseye ring around the area of the tick bite
• Meningococcal disease: individuals should get vaccinate prior to living in a crowded
housing environment (college dorms, prisons, military housing)
• Pertussis: Children w/ pertussis should stay home from school until coughing is gone.
Family members and those exposed should be treated with antimicrobials. Check
immunization status of other children in school.
• TB: Treated with up to 4 antibiotics (to prevent drug resistance) for 6-12 months.
Family members need to be tested for TB. Sputum samples will be needed ever 2-4
weeks – patients are no longer infectious after three negative sputum cultures.
Patients with active TB need to wear N95 masks in public.
Disaster Management: Four levels
• Disaster prevention: surveillance, inspections, immunizations, education, risk
assessment
• Disaster preparedness: create disaster action plan, identify evacuation routes, create
disaster kit, identify meeting place and communication plan, perform disaster drills
• Disaster response: assess extent of disaster. Perform triage, and direct those affected.
Coordinate evacuations, quarantines.
• Disaster recovery: begins when danger no longer exists. Coordinate care in shelters,
homes.
Bioterrorism, Inhaled anthrax, Small pox
• Category A: small pox, botulism, anthrax, plague
• Category B: typhus cholera
• Category C: hantavirus

• Inhaled Anthrax: symptoms: severe dyspnea, fever, shock, muscle aches. Intervention:
IV ciprofloxacin for those exposed (or have high risk of exposure)
• Small pox: symptoms: rash (begins on face and spreads down), high fever, headache,
vomiting. Prevention: vaccination
Consultations vs. Referrals
• Consultation: Request from provider to another physician or resource who can provide
expert advice and/or services for the patient
• Referral: Provider requests or recommends management of one or more of the patient’s
concerns/ issues to another provider or for support services (ex: support groups,
churches, transportation services, meal delivery services)
Case management: Responsibilities
• Help the patient transition from acute to community based care
• Evaluate patient’s medical needs, psychosocial issues, financial constraints
• Collaborate with patient, family, insurance, companies, health care providers, medical
services/ equipment providers to meet the health care needs of the patient
• Facilitate discussion of patient’s needs with an interprofessional team
• Provide referrals as needed
Informatics, Telehealth, Nursing roles in Health Policy
• Informatics: incorporates nursing, information technology, and communication
technology to develop and to support nursing practice and improve patient outcomes
• Telehealth: Delivery of health care through technology (vs. in person). This is
particularly helpful in rural areas, where there is a lack of specialty care services
• Nursing roles in health policy: Nurses can act as an advocate for changes in health
policy, lobby legislators, serve in public office, or help form coalitions (collaboration
of groups to achieve a goal)

VERSION 10
ATI RN COMMUNITY HEALH PROCTORED: FOCUS STUDY GUIDE
Care of specific populations
• Planning care for a pt who has antisocial personality disorder
○ Antisocial personality disorder, borderline, histrionic, and narcissistic are part of
cluster B

○ and is characterized by disregard of others with exploitations, repeat unlawful
actions, deceit, and failure to accept personality responsibility. They have
impulsive behavior, lack of remorse and fail to empathize, they get easily
agitated and aggressive or controlling
○ Nurse needs to set limits with clients who have maladaptive behavior
○ Behavioral therapy through Operant conditioning would change the client
behavior to refrain from manipulating others to earn dining room privileges
• Prior Action for a client who is homeless
○ Refer those who have underlying mental health disorders to therapy and
counseling
○ Enhance parenting skills that can prevent young people from feeling the need
to run away
○ Alleviate the existing homeless by making referrals for financial assistance,
food supplements, and health services
○ Assist homeless clients in locating temporary shelter, and finding ways to meet
long-term shelter
○ If homeless shelters are not provided in the community work with government
officials to develop shelter programs
○ To prevent reoccurrence of poverty, homeless and health problems advocate
and provide effort toward political activity to provide needed services for
people who have mental health disorders and are homeless
○ Make referrals for employee assistance and educational programs to allow
clients who are homeless to eliminate the factors contributing to their
homelessness
○ Families with children are the fasting-growing segment of the homeless
population
• Identifying risk factors for child abuse
○ Unexplained injury
○ Unusual fear of the nurse and others
○ Injuries or wound not mentioned in history
○ Fractures, including older healed fractures
○ Presence of injuries in various stages of healing
○ Subdural hematomas, trauma to genitalia
○ Malnourishment or dehydration

○ General poor hygiene or inappropriate dress for weather conditions
○ Parents consider the child a bad kid.
• Teaching about alcohol withdrawal
○ Irritability
○ Tremors
○ Nausea and vomit
○ Headache
○ Diaphoresis(sweating)
○ Anxiety
○ Sleep disturbances
○ Tachycardia
○ Elevated BP
○ Medication for alcohol withdrawal: benzodiazepines
○ Is important to asses last drink to accurately assess for signs of withdrawal
communicable diseases, disasters and bioterrorism
• Priority action for infectious diarrhea
• Reporting infectious prenatal conditions
○ HIV; is transmitted from mother to neonate prenatally through the placenta and
postnatal through breast milk
○ HIV: laboratory testing recommended in the 3rd trimester for patients who are
at increased risk, ask for informed consent, test begins with antibody
screening test such as enzyme immunoassay, confirmation of positive results
if confirmed by western blot test or immunofluorescence assay.
○ HIV: procedures such as amniocentesis and episiotomy, use of internal fetal
monitors, vacuum extraction, and forceps during labor should be avoided due
to risk of maternal blood exposure
○ Baby should be first bath before giving him injections or blood testing
○ Nursing care; provide conseling prior and after testing, use standard
precautions, encourage vaccination against hepatitis b, pneumococcal
infection, haemophilus influenza type b and viral influenza.
HIV med: Retrovir should be administer at 14 weeks of gestations,
throughout the pregnancy and before the onset of labor or cesarean birth and
is administer to Bab at delivery and for 6 weeks following birth

○ TORCH- acronym for group of infections that can negatively affect a woman
who is pregnant, they can cross placenta and have teratogenic effects on the
foetus
○ TORCH risk factors: toxoplasmosis- is caused by consumption of raw or
undercooked meat or handling cat faces, symptoms similar to influenza or
lymphadenopathy. Other infections can include; hep a and b, syphilis,
mumps, parvovirus b19 and varicella-zoster
○ Torch- measles, rubella, cytomegaly virus hepers simplex virus continuity of
care
• Role of the Case Manager
○ Coordinating care, facilitating continuity of care, improving the efficiency of
care and utilization of resources
○ Enhancing quality of care provided, limiting unnecessary costs and lengthy
stays, advocating for client and family
○ The goal of case management is to avoid fragmentation of care and control
cost
○ Case manager can be a nurse, social worker or the designated health care pro.
They are required to advance practice degrees or advance training in this
area.
○ Case manager nurses do not usually provide direct client care, they oversee a
caseload of clients who have similar disorders or treatment regimens
○ Case managers in community coordinate resources and services for clients
who care is based in a residential setting
○ A critical or clinical pathway or care map can be used to support the
implementation of clinical guidelines and protocol, these tools are usually
based on cost and length of stay parameters mandated by prospective
payment systems such as medicare and insurance companies
• Continuity of care: consultations and referrals, transfers and discharge planning
○ Continuity of care is desired as clients move from one level of care to another
such as from ICU to a medical unit, or from acute care facility to skill care
facility, PACU to post surgical unit
○ Nurses are responsible for facilitating continuity of care and coordinating care
through documentation, reporting and collaboration.

○ A formal written plan of care enhances coordination of care between nurses,
inter pro team members and providers.
○ Nurse role in continuity of care:
▪ Facilitates continuity of care provided by members of the health care
team
▪ Acts as a representative of the client and as a liaison when collaborating
with the provider and other health care team. When acting as a liaison
the nurses serves in the role of client advocate by protecting the rights
of clients and ensuring that the client needs are met
▪ Nurse is responsible for admission, transfer, discharge and post
discharge prescriptions.
▪ Initiation, revision and evaluation of the plan of care
▪ Reporting the clients status to other nurses and provider
▪ Coordinating the discharge plan and facilitating referrals and the use of
community resources
• Assement for a client following a traumatic amputation
○ Nurse needs to monitor capillary refill and compare extremities
○ Observe for edema, necrosis, hair distribuition of extremity due to inadequate
peripheral circulation
○ Manifestations of decrease tissue perfusion: clients may or may not report
pain, altered peripheral pulses (Doppler), differences in temp of extremities,
altered color of extremities, presence of infection and lack of sensation in
affected area
Chapter 30 skin infections and infestations NCC
• Recommended natural treatment for lice
○ Shampoos containing 1% permethrin
○ Remove nits with a nit comb repeat in 7 days after shampoo treatment
○ Wash cloths in hot water with detergent
Chapter 31 anger management MH
• Priority action for violent behavior
○ Provide safe environment for client and others
○ Asses for triggers or preconditions that escalate the client emotions
○ Steps to handle aggressive behavior:
▪ Respond quick in a calm and in control manner

▪ Encourage client to express feelings verbally using therapeutic
communication techniques, allowing the client as much personal
space as possible
▪ Maintaining eye contact and sitting or standing at the same level as the
client
▪ Be honest, sincerity and nonaggressive stance
▪ Avoid accusatory or threating statements
▪ Describing options clearly and offering choices
▪ Reassuring the client that staff members are present to help prevent loss
of control
▪ Set limits for client
▪ Tell him calmly and directly what he must do in a particular situation
such as “I need you to stop yelling and walk with me to the day room
where we can talk,”
▪ Use physical activity, such as walking, to deescalate anger and
behaviors inform the client of the consequences of his behavior such
as loss of privileges
▪ Use pharmacological interventions if the client does not respond to a
limit-setting
▪ Plan for four to six staff members to be available and in sight of the
client as a “show of force” if appropriate
Chapter 18 substance use and addictive disorders MH
• Interventions for gambling
○ Encourage the client in a 12-step program such as gamblers anonymous
▪ Teaching abstinence is necessary for recovery
▪ Higher power is needed to assist in recovery
▪ They are not responsible for their disease but they are responsible
recovery
▪ Others cannot be blamed for their addictions and they must
acknowledge their feelings and problems
Chapter 12 acute neurological disorders
• Priority action for client who has bacterial meningitis
○ Isolate the pt as soon as meningitis is suspected

○ Droplet precautions which require private room or room w cohorts, wearing of
a surgical mask when within 3 ft of the pt, appropriate hand hygiene and use
of designated equipment such as a BP cuff and thermometer
○ Implement fever reduction measures (cooling blanket)
○ Report meningococcal infections to public health dept.
○ Decrease environment stimuli, minimize exposure to bright light
○ Bed rest with HOB – head of the bed ELEVATED 30 Degrees
○ Seizure precautions
○ Replace fluid and electro. Balance
○ Older adults clients are at an increased risk for secondary complications such
as pneumonia
○ Monitor for ICP increase, pupillary changes, widening pulse pressure, decrease
level of consciousness
○ To decrease ICP provide positioning and avoidance of caught and straining,
and mannitol can be administered IV
○ Expected findings: photophobia, nausea, irritable and headache
○ Brudzinki’s sign: severe neck stiffness cause ships and knees to flex when neck
is flexed, 2 years and through adolescence
○ Medications: only for bacterial meningitis, for viral only supportive care
▪ Ceftriaxone (rocephin) or cefotaxime (claforan)
▪ Antibiotics given until culture and sensitivity results are available
▪ Phenytoind(dilantin)- for antivonvulsants given if ICP increases or pt
experiences seizure
▪ Ciprofloxacin( cipro) and rifampin (rifadin) are giving prophylactic
antibiotics to individuals in close contact with pt.
Chapter 11 infection control
• Caring for a client who has c. difficle
○ Withdrawal of causative antibiotic
○ Good skin care
○ Well balanced ite and increase fluid intake
○ Rest periods during acute phase
○ Meds: IV FLUIDS, probiotics, metronidazole oral or IV, Vancomycing as fist
line agent for severe disease
○ Teach family to wear a gown and gloves

○ Wash hands with soap and water, because alcohol base does not remove the
bacteria
Chapter 1 overview of community health nursing
• Planning primary prevention programs
○ Prevention of initial occurrence of disease or injury
○ Nutrition education
○ Family planning
○ Sex ed, smoking cessation education
○ Communicable diseases education
○ Safety education, prenatal classes, providing immunizations
○ Advocating for access to health care and healthy environments
Chapter 2 factors influencing community health
• Counseling and adolescent who is pregnant
○ Refer her to prenatal provider
Chapter 3 health promo. Of infants 2 days to 1 year
• Evaluating parent understanding of infant care
○ Asses family readiness of home care for newborn
○ Asses if they have previous experience or knowledge,
○ Social support received, education needs indicated
○ Sibling rivalry issues,
○ Newborn infants should be placed in car seat at 45 degree angle to prevent
slumping and airway obstruction. Palced rear facing in the rear seat of the
vehicle and secure using the safety belt. Shoulder harness are placed in the
slots at or below the level of the infants shoulder. The harness should be snug
and the retainer clip placed at the level of the infants armpits.
○ Newborns require a checkup by provider within 72hours of discharge,
important for breastfed newborns to evaluate weight and hydration status.
Chapter 4 Practice settings and aggregates
• Teaching about disposal of insulin syringes
○ Place the needle and syring into the shaprs container
○ Do not try to recap the needle after it has been used, do not try to separate the
needle and syringe before disposal

VERSION 11
COMMUNITY HEALTH PROCTORED: LEVEL 3
1. A parish nurse is planning activities for a faith-based community. Which of the activities
should the nurse include?
A) Teach stress management strategies
B) Provide case management
C) Offer primary care to uninsured members
D) Change the negative pressure wound therapy dressing
Answer: A) Teach stress management strategies
2. A nurse is working with a case manager for a client who participates in a health
maintenance organization. The nurse should identify that a health maintenance organization
provides which of the following payment structures?
A) The client pays the insurer a percentage of the total cost for each service rendered by the
provider
B) The provider is paid a fixed sum for the client on a monthly or yearly bases
C) The client is participating in a fee-for service health care insurance program
D) The provider bills the client directly predetermined percentage for the cost of services.
Answer: B) The provider is paid a fixed sum for the client on a monthly or yearly bases
3. A public health nurse is developing protocols to use in emergency shelters following a
disaster. Which of the following should the nurse include as a secondary prevention strategy
for clients who survive a disaster?
A) Providing age-appropriate activities for shelter residents
B) Compiling resources available to transition individuals from shelters to a home
C) Interviewing shelter residents to determine the effectiveness of coping behaviors
D) Publishing a listing of shelter locations in local media source
Answer: B) Compiling resources available to transition individuals from shelters to a home
4. A nurse is conducting home visits to postpartum adolescents who participated in prenatal
parenting classes. Which of the following statements indicates an understanding of the
teaching?
A) I warm my baby bottle in the microwave 30 seconds at a time

B) I limit the time her grandparents cuddle my baby to prevent spoiling
C) I carry my baby with me as I move around the house
D) I use baby talk when talking to my baby
Answer: C) I carry my baby with me as I move around the house
5. A nurse is caring for a client who has hepatitis A. Which of the following reservoirs should
the nurse identify for this infection?
A) Blood
B) Feces
C) Genitourinary tract
D) Skin
Answer: B) Feces
6. A nurse is triaging victims of a commuter train crash. Which of the following clients
should be transported to the Emergency Department first?
A) An ambulatory client whose nose is bleeding and who reports feeling dizzy
B) A client who has a fracture of the humerus with a 2+ radial pulse in the effected arm
C) A client who is exhibiting agonal respirations with fixed pupils
D) A client who has full-thickness burn injuries over 30% of his total body surface area
Answer: D) A client who has full-thickness burn injuries over 30% of his total body surface
area
7. A nurse working in an assisted living care facility is developing a disaster plan. Which of
the following is the first action the nurse should take?
A) Develop response strategies specific to older adults
B) Verify dates of the annual community-wide mass causality drill
C) Determine potential environmental health hazards
D) Identify materials needed for staff and resident education.
Answer: C) Determine potential environmental health hazards
8. An occupational health nurse is completing a walk-through of a factory to identify workers
at risk for injury. Which of the following workers should the nurse identify at being at risk?
A) A worker who is standing in place in extended period and rests one foot on a box
B) A worker standing with a wide base support when pulling a cart towards himself

C) A worker who is 7 weeks postoperative following a rotator cuff surgery and is labeling
boxes.
D) A worker who is wearing a back brace and bends at the waist when picking up a pallet.
Answer: D) A worker who is wearing a back brace and bends at the waist when picking up a
pallet.
9. A nurse is providing teaching to a newly licensed nurse about secondary prevention
strategies related to violence and abuse. Which of the following strategies should the nurse
include in the teaching?
A) Teach a parenting skills class at a child development t center
B) Assess client for withdrawal and passivity during home health visits
C) Refer clients to the appropriate community agency if signs of abuse is evident
D) Coordinate a personal defense program at a local agency
Answer: B) Assess client for withdrawal and passivity during home health visits
10. A community health nurse is working with a migrant population. The nurse should
recognize which of the following interventions is necessary to provide care to this
population?
A) Requiring the clients to show a work visa before they receive care
B) Treating clients on a fee-for-service basis
C) Providing health services at work sites
D) Offer health screenings at a community center
Answer: C) Providing health services at work sites
11. A nurse caring for a client who is homeless. Which of the following actions should the
nurse take first?
A) Assist the client to develop goals for obtaining shelter.
B) Discuss the risks of being homeless with the client
C) Develop client teaching using a variety strategies
D) Determine the client’s understanding of her living situation.
Answer: D) Determine the client’s understanding of her living situation.
12. A nurse is working for a hospice organization. The nurse should identify that which of the
following criteria must be met for a client to qualify for hospice care?

A) The client has declined additional life-prolonging treatments
B) The client requires inpatient care due to lack of a caregiver
C) The client has documentation that states he has less than 12 months to live
D) The client's insurance provides coverage for palliative care
Answer: A) The client has declined additional life-prolonging treatments
13. A nurse is providing teaching to a client about directives regarding end-of life care.
Which of the following information should the nurse include in the teaching?
A) The client can chose a non-family member as the designated power of attorney
B) The living will binding contract between the client and the provider
C) The client family has the authority to revoke the do-not-resuscitate order at any time
D) The client can verbally choose a health care proxy it two nurses witness the designation.
Answer: A) The client can chose a non-family member as the designated power of attorney
14. A home health nurse is planning the initial home visit for a client who has dementia and
lives with his adult son’s family. Which of the following actions should the nurse take first
during the visit?
A) Encourage the family to join a support group
B) Provide the family about respite care
C) Engage the family in informal conversation
D) Educate the family regarding the progression of dementia
Answer: C) Engage the family in informal conversation
15. A nurse educator is teaching a group of newly licensed nurses about maintaining client
confidentially according to HIPAA regulations. Which of the following statements by a newly
licensed nurse indicates an understanding of the teaching?
A) HIPAA rules vary from state to state
B) We should share our computer password with our managers
C) HIPAA rules allows clients to receive a copy of the medical records
D) A client dx can
Answer: C) HIPAA rules allows clients to receive a copy of the medical records
16. A nurse is assessing an outbreak of mumps among school aged children. Using the
epidemiological triangle, the nurse should recognize that which of the following is the host?

A) The vaccine
B) The school
C) The virus
D) The children
Answer: D) The children
17. A home health nurse is caring for a client who has chemotherapy-induced nausea that has
been resistant to relief from pharmacological measures. Which of the following interventions
should the nurse initiate ? (SATA)
A) Offer 120ml(4oz) of cold 2% milk as a meal replacement
B) Maintain the head of the bed in an elevated position after eating
C) Provide sips of room-temperature ginger ale between meals
D) Use seasoning to enhance the flavor of foods
E) Assist the client in using guided imagery
Answer: B) Maintain the head of the bed in an elevated position after eating
C) Provide sips of room-temperature ginger ale between meals
E) Assist the client in using guided imagery
18. A nurse is working with community health care team to devise strategies for preventing
violence in the community. Which of the following interventions is an example of tertiary
prevention?
A) Urging community leaders to make nonviolence a priority
B) Developing resources for victims of abuse
C) Assessing for risk factors of IPV during health examinations
D) Presenting community education programs about stress management
Answer: B) Developing resources for victims of abuse
19. A nurse in an antepartum clinic is reviewing the medical records for 4 clients. Which of
the following infectious conditions should the nurse report to the CDC?
A) Gonorrhea
B) Bactria vaginosis
C) Genital herpes simplex virus
D) HPV
Answer: A) Gonorrhea

20. A home health nurse is caring for a client that has C. diff infection. Which of the
following actions should the nurse take?
A) Instruct the client to avoid use of probiotics
B) Us and ETOH-based hand sanitizer following care
C) Obtain a surgical mask for the client to wear when away from home
D) Clean the client’s bathroom with diluted bleach solution
Answer: D) Clean the client’s bathroom with diluted bleach solution
21. A nurse working in an infectious disease clinic is caring for a client who has a new
diagnosis of Lyme disease. Which of the following agencies is responsible for voluntarily
reporting cases of this disease to CDC?
A) State health department
B) Local red cross chapter
C) Hospital infection control department
D) Office of the surgeon general
Answer: A) State health department
22. A nurse is in a clinic is reviewing home safety precautions with a client who is to begin
radioactive iodine therapy. Which of the following statements by the client indicates an
understanding of the teaching?
A) I will use a toilet that is not used by others in my family
B) I will wait one week after treatment to use a laxative
C) I will allow my granddaughter to visit for 4 hours daily
D) I will use cloth handkerchiefs instead of tissues
Answer: A) I will use a toilet that is not used by others in my family
23. A nurse is teaching a group of clients about ways to prevent skin cancer. Which of the
following statements by the nurse demonstrates a primary prevention strategy?
A) Avoid direct sunlight b/t 10am-4pm
B) Apply cool tap water soaks for 20 mins to relieve sunburn
C) Use acetaminophen as needed for sunburn
D) Ensure you have a yearly skin examination with your provider
Answer: A) Avoid direct sunlight b/t 10am-4pm

24. A community nurse health nurse is working with a task force to decrease community
violence. Which of the following planned interventions should the nurse identify as a primary
prevention strategy?
A) Providing parenting classes for local parents
B) Arranging for a local clinic to provide methadone treatments
C) Providing sexual assault nurse examiner training for nurses in the local clinic
D) Developing protocols for managing victims of violence
Answer: A) Providing parenting classes for local parents
25. A nurse is developing health promotion strategies for older adult clients at an assisted
living facility. Which of the following strategies is the priority for the nurse to include?
A) Schedule annual dental examinations for the clients
B) Encouraging the clients to exercise regularly
C) Immunizing the clients against influenza
D) Providing the clients with low-fat diet
Answer: C) Immunizing the clients against influenza
26. A home health nurse is discussing electrical hazards with a client. Which of the following
statements should the nurse include?
A) You should cover electrical cords with an area rug
B) You should pull on the cord when unplugging items
C) You should limit your use of extension cords
D) You should secure extension cords with clear packaging tape.
Answer: C) You should limit your use of extension cords
27. A nurse is caring for a client who asks “Can I decide not to continue with chemotherapy?”
the nurse responds “This is your choice, and I’ll support whatever decision you make.” The
nurse response is an example of which of the following?
A) Nonmaleficence
B) Veracity
C) Autonomy
D) Beneficence
Answer: C) Autonomy

28. A nurse care manager is providing discharge planning for a client. The nurse is
functioning in which of the following roles when arranging delivery of medical equipment to
the client home?
A) Advocate
B) System allocator
C) Consultant
D) Coordinator
Answer: D) Coordinator
29. A home health nurse is assessing a client who has AIDS. Which of the following
responses by the client indicates a risk for suicide?
A) I know that everything will be better soon
B) I don’t want to lose control of my ability to make decisions.
C) I’m afraid of experiencing pain near the end.
D) I’m relying on my partner more and more for support
Answer: A) I know that everything will be better soon
30. A school nurse is caring for a child who has muscular dystrophy and is having difficulty
swallowing at lunch. Which of the following referrals should the nurse initiate?
A) Dietician
B) Speech-language therapist
C) Respiratory therapist
D) Occupational therapist
Answer: B) Speech-language therapist
31. A nurse in an extended facility enters the room of a client and notices a fire in the trash
can. Which of the following is the nurse’s priority?
A) Move the client to another location
B) Activate the alarm
C) Shut the windows and doors
D) Attempt to extinguish the fire
Answer: A) Move the client to another location

32. A community nurse is teaching a group of parents about manifestations of Alcohol
withdrawal. Which of the following manifestations should the nurse include in the teaching?
A) Hyperglycemia
B) Hypotension
C) Seizures
D) Somnolence
Answer: C) Seizures
33. A nurse is reviewing levels of prevention with a newly licensed nurse. Which of the
following is an example of tertiary prevention?
A) Promoting the use of helmets with children who ride bikes
B) Providing STI testing for students on a college campus
C) Teaching about inhaler use in a client who has asthma
D) Educating adults about breast cancer screening guidelines
Answer: C) Teaching about inhaler use in a client who has asthma
34. A nurse is participating in a quality improvement committee for home health clients.
Which of the following topics should the nurse recommend for the committee to review?
A) An increase in levels of local air pollution
B) An increase in client falls at home
C) An increase in clients receiving annual flu vaccines
D) An increase in client admission for home health care
Answer: B) An increase in client falls at home
35. A first response team is working at the location of a bombing incident. A nurse triaging a
group of clients should give treatment priority to which of the following clients?
A) Client who has a finger fracture with a 2+ pedal pulse
B) A client who has superficial partial thickness burns injuries over 5% of his body
C) A client who is ambulatory in exhibits manic behavior
D) A client who has rigid abdomen with manifestations of shock
Answer: D) A client who has rigid abdomen with manifestations of shock

36. A mental health nurse is scheduling a home health appointment with a client who has
recently lost his partner to a motor vehicle crash. Which of the following statements by the
client indicates a need for immediate nursing intervention?
A) I just feel so angry right now
B) Everything is going to be fine soon
C) There’s no need for anyone to come see me, including you
D) I’m not going to talk to you about my problems
Answer: B) Everything is going to be fine soon
37. A school nurse is planning primary prevention activities for the school year. Which of the
following should the nurse plan to take?
A) Monitor the immunization status of students
B) Provide referrals for students who have asthma
C) Provide first aid for injured students
D) Schedule hearing screening for each grade level
Answer: A) Monitor the immunization status of students
38. A case manager in a rehabilitation facility is discussing discharge plans with a client who
has a pressure injury and requires special beds at home. Which of the following statements
should the nurse make first?
A) A social worker can help you with the cost of supplies
B) Describe the place where you are currently living
C) Apply moisture barrier ointment 3 times a day
D) Eat a balanced diet with high protein snack
Answer: B) Describe the place where you are currently living
39. A community health nurse encounters a client who has suspected bioterrorism- related
illness. Which of the following actions should the nurse take?
A) Report the client’s condition to the FBI
B) Disinfect contaminated areas of the skin with isopropyl alcohol
C) Move the client to a quarantine area
D) Don personal protective equipment
Answer: D) Don personal protective equipment

40. A faith-based organization asks a community health nurse to develop mobile meal
program for older adults who are no longer driving. Which of the following should the nurse
plan to take first?
A) Inquire about availability of volunteers
B) Perform a needs assessment
C) Determine potential funding sources for the program.
D) Identify alternative solutions to address concerns.
Answer: B) Perform a needs assessment
41. A nurse in a mobile clinic is caring for a client who requires a tetanus immunization and
is accompanied by his daughter. The client does not speak the same language as the nurse.
Which of the following actions should the nurse take?
A) Arrange the member of the client’s community to interpret the teaching
B) Use a professional terminology when providing education prior to the procedure
C) Have the client’s daughter communicate information about the procedure
D) Identify the client’s dialect prior to contacting an interpreter
Answer: D) Identify the client’s dialect prior to contacting an interpreter
42. A school nurse is planning primary prevention activities for the new school year. Which
of the following should the nurse include? (SATA)
A) Lobbying for funding for health promotion effects
B) Recommending a seating arrangement for a child in a body cast
C) Creating a plan of care for children who have a diagnosis of DM
D) Organizing a program to promote skateboard safety
E) Teaching a class about the risks of cigarette smoking
Answer: A) Lobbying for funding for health promotion effects
D) Organizing a program to promote skateboard safety
E) Teaching a class about the risks of cigarette smoking
43. An occupational health nurse is assessing agricultural workers for acute effects of
pesticide exposure. Which of the following findings should the nurse expect?
A) Oliguria
B) Dizziness
C) Hypoglycemia

D) Diplopia
Answer: B) Dizziness
44. A home health nurse is caring for a client who has terminal cancer and no longer wants to
receive enteral feeding tube feeding. Which of the following actions should the nurse take?
A) Request the facility Chaplin to visit the client
B) Ask the client to sign an informed consent
C) Complete an against medical advice form
D) Explain the process for completing a living will
Answer: D) Explain the process for completing a living will
45. A nurse is providing teaching to a newly licensed nurse about case management. The
nurse should include which of the following tasks is the responsibility of a case manager?
A) Enforce OSHA standards in the workplace
B) Teach a smoking cessation support group
C) Evaluate the cost effectiveness of client treatments
D) Perform employee risk assessment
Answer: C) Evaluate the cost effectiveness of client treatments
46. A nurse at a rural clinic is interviewing a family who has different cultural beliefs than the
nurse. The family reports seeing a folk healer. Which of the following statements should the
nurse make?
A) Describe how you hope the treatments will affect your health
B) Alternative health practices could be dangerous and should be avoided
C) Many folk medicines treatments work by providing a placebo effect
D) I can refer you to a medical practitioner for your health care needs
Answer: A) Describe how you hope the treatments will affect your health
47. A nurse is planning a primary prevention strategy for reducing obesity in a community.
Which of the following strategies should the nurse use?
A) Educate children at a day care center about nutrition and exercise
B) Measure the BMI of older adults at a community center
C) Encourager enrollment and attendance at a weight0-reduction program
D) Distribute health risk appraisal questionnaires at community functions

Answer: A) Educate children at a day care center about nutrition and exercise
48. A nurse in a community health clinic is assessing a client who has 2 preschoolers, was
recently divorced, and is seeking help for managing depression. Which of the following
statements should the nurse ask first?
A) Are you having any thoughts of hurting yourself
B) Who is available to help you
C) Could you describe how you are feeling today
D) Is there anything that makes you feel less depressed
Answer: A) Are you having any thoughts of hurting yourself
49. A nurse is teaching a client who has terminal illness about hospice care. Which of the
following statements by the client indicates an understanding of the teaching? (SATA)
A) My provider will recommend that I enter hospice care when I have 1 year left to live
B) I will receive care from a variety of interprofessional team members
C) I can discontinue hospice care whenever I want
D) I will need to have a private insurance because Medicare does not cover hospice care
E) I can receive care in the hospital or at home
Answer: B) I will receive care from a variety of interprofessional team members
C) I can discontinue hospice care whenever I want
E) I can receive care in the hospital or at home
50. A nurse is teaching a to a 50-year-old female client. Which of the following statement
should the nurse include in the teaching?
A) You should have a complete eye exam every 2 years until the age of 64.
B) You should have your stool tested for blood every other year until the age of 74
C) You should have your hearing screened every 5 years
D) You should have your fasting Blood glucose level checked every 6 years
Answer: A) You should have a complete eye exam every 2 years until the age of 64.
51. A nurse is serving a state task force for disaster planning. The nurse is engaging in
disaster preparedness efforts when performing which of the following actions?
A) Functioning as a manager at a temporarily shelter
B) Assisting with the identification of biological agent

C) Implementing a disaster triage plan with the local medical facility
D) Organizing a mass causality drill for community members
Answer: D) Organizing a mass causality drill for community members
52. A nurse is planning an in-service about isolation precautions for her coworkers. For which
of the following infections should the nurse identify the need for contact precautions.
A) Herpes simplex
B) Pertussis
C) Diphtheria
D) Pulmonary tuberculosis
Answer: A) Herpes simplex
53. A home health nurse is performing and eye assessment for an older adult client. Which of
the following is the priority for the nurse to report to the provider?
A) Conjunctivitis
B) Hemianopia
C) Decreased near vision
D) Increased sensitivity to glare
Answer: B) Hemianopia
54. A nurse at a community clinic is assessing a client who reports injecting heroin an 1hr
ago. Which of the following should the nurse expect?
A) Nystagmus
B) Tachypnea
C) Euphoria
D) Dilatated pupils
Answer: D) Dilatated pupils
55. A nurse manager at a clinic is reviewing the preventive services offered to clients. Which
of the following activities should the nurse identify as a secondary prevention activity?
A) Encourage a pregnant woman to participate in a prenatal care class
B) Provide smoking cessation class
C) Advocate for laws that prohibit texting while driving
D) Refer a client who is recovering from a substance use disorder to social service program.

Answer: B) Provide smoking cessation class
56. A parish nurse is counseling a family following a client’s recent dx with heart diseases.
Which of the following actions should the nurse take first?
A) Assist the client and the client partner finding an affordable exercise program
B) Discuss the benefits of eating a well-balanced diet with the client’s family
C) Ask family about the impact of the disease on relationships within the family
D) Offer to accompany the client and the client’s partner during health care provider visits
Answer: C) Ask family about the impact of the disease on relationships within the family
57. A home health nurse is providing teaching to the guardian of a child who has leukemia
about methods to prevent complications. Which of the following statements by the guardian
indicates an understanding of the teaching?
A) I’m sure my child will feel better now that he can ride his bike
B) I should inspect my child’s mouth for sores
C) I should take my child’s rectal temperature daily
D) I will make sure my child gets his MMR vaccination this week
Answer: B) I should inspect my child’s mouth for sores
58. A school nurse is planning a safety education for a group of adolescents. The nurse should
give priority to which of the following topics as the leading cause of death in this age group?
A) Gun safety
B) Motor vehicle safety
C) Substance abuse prevention
D) Sports injury prevention
Answer: B) Motor vehicle safety
59. A case manager is completing discharge planning for a client who has alcohol use
disorder and cirrhosis of the liver. Which of the following actions should the case manager
take first?
A) Contact a social worker to assist the client with managing finances.
B) Provide client information on self-help groups for alcohol use disorder
C) Determine which home safety measure the client will need to implement
D) Arrange for a home health nurse to visit the client following discharge.

Answer: D) Arrange for a home health nurse to visit the client following discharge.
60. A nurse in a community clinic is preparing and educational guide about cultural variances
in expression of pain. Which of the following information should the nurse include?
A) Puerto Rican cultural practices include the view that outspoken expression of pain is
shameful.
B) Middle eastern cultural practices include hiding pain from close family members
C) Native Americans cultural practices include being outspoken about pain.
D) Chinese cultural practices include enduring pain to prevent family dishonor
Answer: D) Chinese cultural practices include enduring pain to prevent family dishonor

VERSION 12
1. A community health nurse observes the accumulation of garbage at a neighborhood
playground. Which of the following actions should the nurse take to promote a clean and safe
environment?
A) Work with local businesses to sponsor more trash receptacles in the playground
B) Meet with community members to discuss methods of playground maintenance
C) Partner City officials with community members to improve the playgrounds condition
D) Engage neighborhood families to monitor the playground for further trash build up
Answer: B) Meet with community members to discuss methods of playground maintenance
2. Nurse is planning the initial home visit for a client who has dementia and lives with his
adult Sons family. Which of the following actions should the nurse take first during the visit?
A) Educate the family regarding the progression of dementia
B) engage the family in informal conversation
C) provide the family with information about respite care
D) encourage the family to join a support group
Answer: A) Educate the family regarding the progression of dementia
3. A community health nurse is providing teaching to a group of clients who have alcohol use
disorder. Which of the following findings should the nurse include in the teaching as a
manifestation of alcohol withdrawal?

A) Bradycardia
B) Hypothermia
C) Insomnia
D) increased appetite
Answer: C) Insomnia
4. A nurse is counseling a client who is to undergo enzyme-linked immunosorbent assay
testing for HIV. Which of the following information should the nurse include?
A) The test measures antibodies to the virus
B) the test results are accurate 24 hours after exposure to the virus
C) a positive result requires initiating immunoglobulin Administration
D) the test monitors progression of the disease
Answer: A) The test measures antibodies to the virus
5. A nurse is working with a Community Health Care team to devise strategies for preventing
violence in the community. Which of the following interventions is example of tertiary
prevention?
A) Assessing for risk factors of intimate partner abuse during Health examinations
B) presenting Community Education programs about Stress Management
C) Urging community leaders to make nonviolence a priority
D) Developing resources for victims of abuse
Answer: A) Developing resources for victims of abuse
6. A faith-based organization ask a community health nurse to develop on mobile meal
program for older adults who are no longer driving. Which of the following actions should
the nurse plan to take first?
A) perform a needs assessment
B) inquire about the availability of volunteers
C) identify alternative solutions to address concerns
D) determine potential funding sources for the program
Answer: A) perform a needs assessment
7. A nurse is planning a primary prevention strategy for reducing obesity in the community.
Which of the following strategies should the nurse use?

A) Educate children at a daycare about nutrition and exercise
B) measure the BMI of older adults at a community Senior Center
C) encourage enrollment and attendance at weight reduction programs
D) distribute health risk appraisal questionnaires at Community functions
Answer: A) Educate children at a daycare about nutrition and exercise
8. Several nurses are developing a parish nurse group to help adjust the primary and
secondary health care needs of a congregation. Which of the following Services should the
nurses plan to provide to the congregation?
A) provide end-of-life care for members who are terminal
B) perform wound care in the home of members
C) facilitate discharge from the facility to the home
D) organize an influenza immunization clinic with American Red Cross
Answer: D) organize an influenza immunization clinic with American Red Cross
9. A nurse is conducting a community assessment. Which of the following information should
the nurse include as part of the windshield survey?
A) Demographic data
B) housing quality
C) informant interviews
D) mortality rates
Answer: B) housing quality
10. A client who has diabetes mellitus asks a home health nurse to help her adapt some of her
traditional cultural foods to fit her meal plan. Which of the following is the first action the
nurse should take when assisting this client?
A) Explain the diabetes exchange list
B) use cookbooks to include traditional foods and meal plans
C) observe the client during preparation of traditional foods
D) provide the client with printed recipes
Answer: A) Explain the diabetes exchange list
11. A school nurse is implementing Health screenings. Which of the following assessment
findings should the nurse recognize as the highest priority?

A) A child who has nits
B) An Adolescent who has scoliosis
C) and Adolescent who has psoriasis
D) a child who has a BMI of 18
Answer: A) A child who has nits
12. The first response team is working at the location of a bombing incident. The nurse
triaging a group of clients should give treatment priority to which of the following clients?
A) A client who has a femur fracture with a 2 + pedal pulse
B) a client who has a rigid abdomen With manifestations of shock
C) a client who has superficial partial thickness burn injuries over 5% of his body
D) a client who is ambulatory and Exhibits manic behavior
Answer: B) a client who has a rigid abdomen With manifestations of shock
13. A 35 year old client who has a diagnosis of tuberculosis informs the provider's office that
she is unable to pay for the treatment. Which of the following actions by the nurse will
facilitate obtaining appropriate treatment?
A) Explore options for alternative Therapies
B) arrange for medication through local agencies
C) send the clients to the nearest facility for further evaluation
D) help the client apply for Medicare
Answer: D) help the client apply for Medicare
14. A home health nurses scheduled for first-time visit to a client. Which of the following
should the nurse perform first?
A) Mental status examination
B) review of the neighborhood
C) family history
D) blood pressure screening
Answer: D) blood pressure screening
15. A nurse is working in a shelter following a disaster. Which of the following is the priority
action for the nurse to take?
A) Explore feelings the clients are experiencing

B) create diversionary activities for children
C) help clients gather needed supplies
D) address the physical needs of clients
Answer: D) address the physical needs of clients
16. A community health nurse is educating up here in about the importance of hepatitis B
immunization. Which of the following explanations should the nurse give to a parent about
the disease?
A) People who have had hepatitis B infection still need the immunization
B) Hepatitis B spreads easily among children through casual contact
C) many people who acquire acute hepatitis B develop chronic hepatitis
D) One dose of the immunization gives children life-long protection from hepatitis B
Answer: C) many people who acquire acute hepatitis B develop chronic hepatitis
17. A nurse at a community clinic is preparing an educational guide about cultural variances
and expression of pain. Which of the following information should the nurse include?
A) Native American Cultural practices include being outspoken about pain
B) Chinese Cultural practice include and during pain to prevent family dishonor
C) Puerto Rican cultural practices include the view that outspoken expressions of pain are
shameful
D) Middle Eastern cultural practices include hiding pain from close family members
Answer: B) Chinese Cultural practice include and during pain to prevent family dishonor
18. A nurse is providing education to the family of a school-age child who has pertussis.
Which of the following information should the nurse include in the teaching?
A) Household contacts will receive prophylactic antibiotics
B) transmission will be limited because of the herd immunity
C) the child is most contagious after the rash develops
D) a dehumidifier should be placed beside the child's bed
Answer: A) Household contacts will receive prophylactic antibiotics
19. A partner of an older client who has Alzheimer's disease reports that he is not eating. The
home health aide tells the nurse that the clients partner refuses to assist a client with feeding.

The partner and sister client feed himself without help. Which of the following is the priority
action the nurse should take?
A) refer the clients partner to an Alzheimer's support group
B) direct the home health aide to assist with meals
C) determine the client's ability to self-feed
D) arrange for meals-on-wheels assistance
Answer: C) determine the client's ability to self-feed
20. A community nurse is planning a smoking cessation class. Which of the following factors
will have the greatest effect on the success of the class?
A) Client education level
B) presenters teaching strategies
C) presenters credibility
D) clients motivation
Answer: D) clients motivation
21. A nurse is planning a program about healthy eating at an elementary school where most
students select French fries and pizza at lunch every day. Which of the following actions
should the nurse plan to take first?
A) Provide students with resources about making wise choices independently
B) help students recognize the value of making healthy food choices
C) give positive feedback to students who make appropriate choices
D) determined students motivation to learn about healthy food choices
Answer: D) determined students motivation to learn about healthy food choices
22. A community health nurse is caring for clients in a culturally diverse Community. Which
of the following actions demonstrates accurate cultural knowledge about a specific cultural
group?
A) Maintaining eye contact when interviewing a Native American client
B) including both hot and cold food items on a Hispanic client menu
C) touching the hair of an African American client during an assessment
D) offering to shake hands when meeting an Asian client of the opposite gender
Answer: D) offering to shake hands when meeting an Asian client of the opposite gender

23. A nurse is discussing short and long-term goals with a client who has alcohol use disorder
and is being admitted to a treatment facility. Which of the following statements is appropriate
for the nurse to include in the discussion?
A) Attending Al-Anon meetings will help you identify role model to assist you with making
needed changes
B) remaining Physically Active will help minimize drowsiness and chills associated with
initial alcohol withdrawal
C) you will begin learning functional skills to replace defense mechanisms and behaviors
while in treatment
D) you will be taking a once weekly dose of disulfiram to help control withdrawal symptoms
during treatment
Answer: C) you will begin learning functional skills to replace defense mechanisms and
behaviors while in treatment
24. A public health nurse is addressing Community leaders at a forum about Community
Improvement. The nurse should identify which of the following groups as being the fastest
moving segment of the homeless population?
A) Families who have children
B) men who are unemployed
C) adolescent Runaways
D) people who have substance use disorders
Answer: A) Families who have children
25. A nurse case manager is providing discharge planning for a client. The nurse is
functioning in which of the following roles when arranging for the delivery of medical
equipment to the clients home.
A) Consultant
B) Coordinator
C) Advocate
D) systems allocators
Answer: B) Coordinator
26. A nurse at a local Health Department is caring for several clients. Which of the following
infection should the nurse report to the State Health Department?

A) Herpes simplex virus
B) Group B streptococcus b hemolytic
C) Chlamydia
D) human papillomavirus
Answer: C) Chlamydia
27. A nurse manager in a local community health agency is creating job description for a new
nurse who will practice community-oriented nursing. Which of the following should the
nurse include in the job description? Select all that apply
A) provide wound care for clients in their homes
B) participate in local Health surveillance activities
C) initiate support groups for parents of autistic children
D) provide health-related education to community groups
E) Investigate potential health and environmental issues
Answer: C) initiate support groups for parents of autistic children
D) provide health-related education to community groups
28. The community health nurse is interviewing a client who reports intimate partner abuse.
Which of the following actions should the nurse take?
A) Assist the client to create a plan of Escape
B) ask 3 nurses of the same gender as the client to participate in the interview
C) communicate disapproval of the partners actions
D) record a summary of the clients description of the event
Answer: D) record a summary of the clients description of the event
29. A nurse is caring for a client who is having difficulty performing activities of daily living.
The nurse is functioning in which of the following rules when arranging for an occupational
therapist to visit the client?
A) Administrator
B) nurse consultant
C) case manager
D) Clinician
Answer: C) case manager

30. A nurse in a mobile Health Clinic is caring for a client who requires a tetanus
immunization and is accompanied by his daughter. The client does not speak the same
language as the nurse. Which of the following actions should the nurse take?
A) Arrange for the member of the client’s community to interpret the teaching
B) identify the clients spoken dialect prior to contacting an interpreter
C) have the clients daughter communicate information about the procedure
D) use professional terminology when providing education prior to the procedure
Answer: B) identify the clients spoken dialect prior to contacting an interpreter
31. An occupational health nurse is discussing health promotion with a client who has a
history of obesity. Which of the following comments indicates the client is using
rationalization as a coping mechanism?
A) I am obese because it is in my genes
B) I have difficulty resisting the items in vending machines
C) I know you don't like me because I am obese
D) I have lots of health problems from being obese
Answer: A) I am obese because it is in my genes
32. A home health nurse is caring for a client who has chemotherapy induced nausea that has
been resistant to relief from pharmacological measures. Which of the following interventions
should the nurse initiate?
A) Assist the client and using guided imagery
B) maintain the head of the bed in the elevated position after eating
C) provide steps of room temperature ginger ale between meals
D) offer 120 ml of cold 2% milk as a meal replacement
E) using seasonings to enhance the flavor of foods
Answer: A) Assist the client and using guided imagery
B) maintain the head of the bed in the elevated position after eating
E) using seasonings to enhance the flavor of foods
33. A parish nurse is counseling a family following a client's recent diagnosis for heart
disease. Which of the following actions should the nurse take first?
A) Discuss the benefits of eating a well-balanced diet with the client's family
B) assist the client and the clients partner with finding an affordable exercise program

C) Ask family members about the impact of the disease and relationships within the family
D) offer to accompany the client and the client partner during healthcare provider visits
Answer: C) Ask family members about the impact of the disease and relationships within the
family
34. A school nurse is playing safety education for a group of adolescents. The nurse should
give priority to which of the following topics as the leading cause of death for this age group?
A) Sports Injury prevention
B) Motor Vehicle Safety
C) gun safety
D) Substance Abuse Prevention
Answer: B) Motor Vehicle Safety
35. A nurse is serving on a state task force for disaster planning. The nurse is engaging a
disaster preparedness effort when performing which of the following actions?
A) Organizing a mass casualty drill for community members
B) function as a manager at a temporary shelter
C) assisting with the identification of a biological agent
D) implementing a disaster triage plan with local medical facility
Answer: A) Organizing a mass casualty drill for community members
36. During a home health visit, a school-age child who has muscular dystrophy confides in
the nurse that he was struck by his parent. Which of the following actions should the nurse
take first?
A) Enroll the parent and anger management classes
B) check the child for injuries
C) report the incident to the local authorities
D) refer the parent to a Social Service Agency
Answer: B) check the child for injuries
37. A nurse is preparing an educational program about breastfeeding for a group of new
parents. The nurse should use which of the following is structural strategies to promote
psychomotor learning?
A) facilitated Discussion Group about the benefits of breastfeeding

B) provide dolls for the participants to demonstrate positioning
C) show the group of video on breastfeeding techniques
D) review flashcards identify holding techniques with the group
Answer: B) provide dolls for the participants to demonstrate positioning
38. A Community Health Clinic nurse manager is reviewing the incidence rate of chlamydia
in the state. In a given year 3144 new cases were reported and the population was estimated
at 325986. Which of the following is the incidence rate in the state for the year?
A) about 10 reported cases per 1000 population
B) about three reported cases per 10,000 population
C) about 300 reported cases per 100,000 population
D) about one reported case per 10,000 population
Answer: A) about 10 reported cases per 1000 population
39. An occupational health nurse is assisting agricultural workers for acute effects of
pesticide exposure. Which of the following findings should the nurse expect?
A) Dizziness
B) Oliguria
C) Diplopia
D) Hypoglycemia
Answer: A) Dizziness
40. The nurses working with the case manager for a client who participates in the health
maintenance organization. The nurse should identify that the health maintenance organization
provides which of the following payment structures?
A) The client is participating a fee for service healthcare insurance program
B) the provider is paid a fixed sum for the client on a monthly basis or yearly basis
C) the client pays the insurer of percentage of the total cost for each service rendered by the
provider
D) to provide our bills the client directly for predetermined percentage of the cost of services
Answer: B) the provider is paid a fixed sum for the client on a monthly basis or yearly basis
41. A newly-hired occupational health nurse is assisting hazards in the work environment.
Which of the following actions will help the nurse detect potential physical hazards?

A) identify industrial toxins that are present in the environment
B) survey workers about job-related emotional stress
C) track rates of illness caused by infection among employees
D) measure noise levels at various locations in the facility
Answer: A) measure noise levels at various locations in the facility
42. My client arrives at a mental health clinic and tells the nurse she has no purpose in life.
Which of the following is the nurses priority response?
A) How long have you been feeling this way?
B) Tell me what is going on with you right now
C) do you really think your life has no purpose?
D) Have you been thinking about harming yourself?
Answer: D) Have you been thinking about harming yourself?
43. In the last month, three cases of tuberculosis have been referred to the health department.
Which of the following is a priority information for the community health nurse to obtain
from each client?
A) Household members
B) health history
C) Demographics
D) Occupation
Answer: A) Household members
44. A nurse is assessing an outbreak of mumps among school-age children. Using that
epidemiological triangle, The nurse should recognize that which of the following is the host?
A) The virus
B) the vaccine
C) the children
D) the school
Answer: C) the children
45. A nurse is working in an infectious disease clinic is caring for a client who has a new
diagnosis of lyme disease. Which of the following agencies is responsible for voluntarily
reporting cases of the disease to the Center for Disease Control and prevention?

A) State Health Department
B) Office of the Surgeon General
C) local Red Cross chapter
D) hospital infection control Department
Answer: A) State Health Department
46. A nurse is providing education to a group of adolescents who are pregnant and attending
High School. Which of the following information should the nurse include in the teaching?
A) The incidence of higher birth weight infants is higher in adolescent pregnancy
B) pregnant adolescents need to gain less weight than adult mothers
C) Caffeinated beverages should be replaced with caffeine-free beverages
D) the need for supplemental folic acid is greatest during the third trimester
Answer: C) Caffeinated beverages should be replaced with caffeine-free beverages
47. A nurse is caring for a client who is homeless. Which of the following actions should the
nurse take first?
A) Develop client teaching using a variety of strategies
B) discuss the risks of being homeless with the client
C) determine the client's understanding of her living situation
D) assist the client to develop goals for obtaining shelter
Answer: C) determine the client's understanding of her living situation
48. A nurse is working to reduce individual and family violence in the local community.
Which of the following actions by the nurse demonstrates a primary prevention strategy to
achieve this goal?
A) Assessing a family for marital Discord
B) providing treatment for a young adult who has substance use disorder
C) teaching parenting techniques to new parents
D) conducting counseling for at-risk parents
Answer: C) teaching parenting techniques to new parents
49. A community health nurse is providing screening for lipid disorders. Which of the
following is the primary goal of this activity?
A) Client enrollment and prevention programs

B) early detection of disease
C) identification of family history of medical problems
D) promotion of appropriate Lifestyle Changes
Answer: D) promotion of appropriate Lifestyle Changes
50. A nurse is providing teaching to a 50 year old female client. Which of the following
statements should the nurse include in the teaching?
A) You should have a complete eye examination every two years until the age of 64
B) you should have your fasting blood glucose level checked every 6 years
C) you should have your hearing screened every 5 years
D) you should have your stool tested for blood every other year until the age of 74
Answer: A) You should have a complete eye examination every two years until the age of 64
51. A community health nurse is planning a program for adolescents about preventing STIs.
Which of the following actions should the nurse take first?
A) Establish methods to evaluate program outcomes
B) obtain visual aids that feature adolescence
C) provide computer based education
D) collect data to identify barriers to learning
Answer: D) collect data to identify barriers to learning
52. A community health nurse is planning an educational program for a group of women who
are post-menopausal. which of the following outcomes is appropriate for this program?
A) Clients will schedule bone density screens
B) clients will start hormone replacement therapy
C) clients will arrange for a mammogram every 3 years
D) clients will significantly decrease caloric intake
Answer: A) Clients will schedule bone density screens
53. A home health nurse manager is caring for a client who has methicillin-resistant
staphylococcus aureus. Which of the following actions should the nurse take?
A) remove fresh flowers from the clients room
B) double bag soil dressing in polyethylene bags
C) wear a mask when within 3 feet of the client

D) Advise the client to use a HEPA filter in the house
Answer: A) remove fresh flowers from the clients room
54. A nurse is counseling a client who has a new diagnosis of chlamydia. Which of the
following information should the nurse include in teaching?
A) Notify anyone with whom you had sexual contact over the past 2 months
B) you might experience painful urination until the infection has resolved
C) once you complete treatment, you'll have an acquired immunity against chlamydia
D) you will need to take an antiviral medication for 30 days
E) you should avoid sexual contact until therapy is complete
Answer: A) Notify anyone with whom you had sexual contact over the past 2 months
E) you should avoid sexual contact until therapy is complete
55. A community health nurse working with a group of homeless veterans who has posttraumatic stress disorder. Which of the following interventions should the nurse implement?
A) Change the meeting sites frequently
B) teach the clients to practice deep breathing exercises
C) provide coffee and snacks during the meetings
D) avoid discussing the traumatic events experienced by the veterans
Answer: B) teach the clients to practice deep breathing exercises
56. A clinic nurse is assessing a client who has the measles. Which of the following findings
should the nurse expect?
A) Muscle aches and tenderness
B) persistent low-grade temperature
C) rash confined to the trunk of the body
D) koplik spots inside the mouth
Answer: D) koplik spots inside the mouth
57. A nurse at a shelter assisting with client triage after tornado destroyed a community.
Which of the following clients should receive Priority Care?
A) A school-age client who has a head abrasion
B) an adult client who is short of breath
C) an infant client who is crying

D) an older adult client who has a fractured arm
Answer: D) an adult client who is short of breath
58. A nurse is triaging clients who were involved in a commuter train crash. Which of the
following clients should the nurse choose for transport to the emergency department first?
A) A client who has a fracture of the humerus with a 2 + radial pulse in the affected arm
B) and ambulatory client who has a nosebleed and reports feeling dizzy
C) A client who has full thickness burn injury over 30% of his total body surface area
D) a client who is exhibiting agonal respirations with fixed dilated pupils
Answer: C) A client who has full thickness burn injury over 30% of his total body surface
area
59. A government official reports to the health department that an employee was possibly
exposed to Anthrax. Which of the following actions should the public health nurse take?
A) Refer co-workers who might have been exposed to a provider for prophylactic antibiotics
B) Alert all of the family members of co-workers about their possible exposure to anthrax
C) instruct the client to wear a mask at work
D) place the employee under quarantine for 14 days
Answer: B) Alert all of the family members of co-workers about their possible exposure to
anthrax
60. A home health nurse is visiting a client who has had a stroke 2 months ago. Which of the
following findings should the nurse report to the interprofessional care team?
A) the client Bears weight on her arms when using the crutches
B) the clients caregiver bills a pill organizer weekly
C) the client coughs when swallowing her medications
D) the client dresses her affected side first
Answer: C) the client coughs when swallowing her medications

VERSION 13

3. A community health nurse observes the accumulation of garbage at a neighborhood
playground. Which of the following actions should the nurse take to promote a clean and safe
environment?
A) Work with local businesses to sponsor more trash receptacles in the playground
B) Meet with community members to discuss methods of playground maintenance
C) Partner City officials with community members to improve the playgrounds condition
D) Engage neighborhood families to monitor the playground for further trash build up
Answer: B) Meet with community members to discuss methods of playground maintenance
4. Nurse is planning the initial home visit for a client who has dementia and lives with his
adult Sons family. Which of the following actions should the nurse take first during the visit?
A) Educate the family regarding the progression of dementia
B) engage the family in informal conversation
C) provide the family with information about respite care
D) encourage the family to join a support group
Answer: A) Educate the family regarding the progression of dementia
5. A community health nurse is providing teaching to a group of clients who have alcohol use
disorder. Which of the following findings should the nurse include in the teaching as a
manifestation of alcohol withdrawal?
A) Bradycardia
B) Hypothermia
C) Insomnia
D) increased appetite
Answer: C) Insomnia
4. A nurse is counseling a client who is to undergo enzyme-linked immunosorbent assay
testing for HIV. Which of the following information should the nurse include?
A) The test measures antibodies to the virus
B) the test results are accurate 24 hours after exposure to the virus
C) a positive result requires initiating immunoglobulin Administration
D) the test monitors progression of the disease
Answer: A) The test measures antibodies to the virus

5. A nurse is working with a Community Health Care team to devise strategies for preventing
violence in the community. Which of the following interventions is example of tertiary
prevention?
A) Assessing for risk factors of intimate partner abuse during Health examinations
B) presenting Community Education programs about Stress Management
C) Urging community leaders to make nonviolence a priority
D) Developing resources for victims of abuse
Answer: D) Developing resources for victims of abuse
6. B faith-based organization ask a community health nurse to develop on mobile meal
program for older adults who are no longer driving. Which of the following actions should
the nurse plan to take first?
A) perform a needs assessment
B) inquire about the availability of volunteers
C) identify alternative solutions to address concerns
D) determine potential funding sources for the program
Answer: A) perform a needs assessment
7. A nurse is planning a primary prevention strategy for reducing obesity in the community.
Which of the following strategies should the nurse use?
A) Educate children at a daycare about nutrition and exercise
B) measure the BMI of older adults at a community Senior Center
C) encourage enrollment and attendance at weight reduction programs
D) distribute health risk appraisal questionnaires at Community functions
Answer: A) Educate children at a daycare about nutrition and exercise
8. Several nurses are developing a parish nurse group to help adjust the primary and
secondary health care needs of a congregation. Which of the following Services should the
nurses plan to provide to the congregation?
A) provide end-of-life care for members who are terminal
B) perform wound care in the home of members
C) facilitate discharge from the facility to the home
D) organize an influenza immunization clinic with American Red Cross
Answer: D) organize an influenza immunization clinic with American Red Cross

9. A nurse is conducting a community assessment. Which of the following information should
the nurse include as part of the windshield survey?
A) Demographic data
B) housing quality
C) informant interviews
D) mortality rates
Answer: B) housing quality
10. A client who has diabetes mellitus asks a home health nurse to help her adapt some of her
traditional cultural foods to fit her meal plan. Which of the following is the first action the
nurse should take when assisting this client?
A) Explain the diabetes exchange list
B) use cookbooks to include traditional foods and meal plans
C) observe the client during preparation of traditional foods
D) provide the client with printed recipes
Answer: A) Explain the diabetes exchange list
11. A school nurse is implementing Health screenings. Which of the following assessment
findings should the nurse recognize as the highest priority?
A) A child who has nits
B) An Adolescent who has scoliosis
C) and Adolescent who has psoriasis
D) a child who has a BMI of 18
Answer: A) A child who has nits
12. The first response team is working at the location of a bombing incident. The nurse
triaging a group of clients should give treatment priority to which of the following clients?
A) A client who has a femur fracture with a 2 + pedal pulse
B) a client who has a rigid abdomen With manifestations of shock
C) a client who has superficial partial thickness burn injuries over 5% of his body
D) a client who is ambulatory and Exhibits manic behavior
Answer: B) a client who has a rigid abdomen With manifestations of shock

13. A 35 year old client who has a diagnosis of tuberculosis informs the provider's office that
she is unable to pay for the treatment. Which of the following actions by the nurse will
facilitate obtaining appropriate treatment?
A) Explore options for alternative Therapies
B) arrange for medication through local agencies
C) send the clients to the nearest facility for further evaluation
D) help the client apply for Medicare
Answer: D) help the client apply for Medicare
14. A home health nurses scheduled for first-time visit to a client. Which of the following
should the nurse perform first?
A) Mental status examination
B) review of the neighborhood
C) family history
D) blood pressure screening
Answer: D) blood pressure screening
15. A nurse is working in a shelter following a disaster. Which of the following is the priority
action for the nurse to take?
A) Explore feelings the clients are experiencing
B) create diversionary activities for children
C) help clients gather needed supplies
D) address the physical needs of clients
Answer: D) address the physical needs of clients
16. A community health nurse is educating up here in about the importance of hepatitis B
immunization. Which of the following explanations should the nurse give to a parent about
the disease?
A) People who have had hepatitis B infection still need the immunization
B) Hepatitis B spreads easily among children through casual contact
C) many people who acquire acute hepatitis B develop chronic hepatitis
D) One dose of the immunization gives children life-long protection from hepatitis B
Answer: C) many people who acquire acute hepatitis B develop chronic hepatitis

17. A nurse at a community clinic is preparing an educational guide about cultural variances
and expression of pain. Which of the following information should the nurse include?
A) Native American Cultural practices include being outspoken about pain
B) Chinese Cultural practice include and during pain to prevent family dishonor
C) Puerto Rican cultural practices include the view that outspoken expressions of pain are
shameful
D) Middle Eastern cultural practices include hiding pain from close family members
Answer: B) Chinese Cultural practice include and during pain to prevent family dishonor
18. A nurse is providing education to the family of a school-age child who has pertussis.
Which of the following information should the nurse include in the teaching?
A) Household contacts will receive prophylactic antibiotics
B) transmission will be limited because of the herd immunity
C) the child is most contagious after the rash develops
D) a dehumidifier should be placed beside the child's bed
Answer: A) Household contacts will receive prophylactic antibiotics
19. A partner of an older client who has Alzheimer's disease reports that he is not eating. The
home health aide tells the nurse that the clients partner refuses to assist a client with feeding.
The partner and sister client feed himself without help. Which of the following is the priority
action the nurse should take?
A) refer the clients partner to an Alzheimer's support group
B) direct the home health aide to assist with meals
C) determine the client's ability to self-feed
D) arrange for meals-on-wheels assistance
Answer: C) determine the client's ability to self-feed
20. A community nurse is planning a smoking cessation class. Which of the following factors
will have the greatest effect on the success of the class?
A) Client education level
B) presenters teaching strategies
C) presenters credibility
D) clients motivation
Answer: D) clients motivation

21. A nurse is planning a program about healthy eating at an elementary school where most
students select French fries and pizza at lunch every day. Which of the following actions
should the nurse plan to take first?
A) Provide students with resources about making wise choices independently
B) help students recognize the value of making healthy food choices
C) give positive feedback to students who make appropriate choices
D) determined students motivation to learn about healthy food choices
Answer: D) determined students motivation to learn about healthy food choices
22. A community health nurse is caring for clients in a culturally diverse Community. Which
of the following actions demonstrates accurate cultural knowledge about a specific cultural
group?
A) Maintaining eye contact when interviewing a Native American client
B) including both hot and cold food items on a Hispanic client menu
C) touching the hair of an African American client during an assessment
D) offering to shake hands when meeting an Asian client of the opposite gender
Answer: D) offering to shake hands when meeting an Asian client of the opposite gender
25. A nurse is discussing short and long-term goals with a client who has alcohol use disorder
and is being admitted to a treatment facility. Which of the following statements is appropriate
for the nurse to include in the discussion?
A) Attending Al-Anon meetings will help you identify role model to assist you with making
needed changes
B) remaining Physically Active will help minimize drowsiness and chills associated with
initial alcohol withdrawal
C) you will begin learning functional skills to replace defense mechanisms and behaviors
while in treatment
D) you will be taking a once weekly dose of disulfiram to help control withdrawal symptoms
during treatment
Answer: C) you will begin learning functional skills to replace defense mechanisms and
behaviors while in treatment

26. A public health nurse is addressing Community leaders at a forum about Community
Improvement. The nurse should identify which of the following groups as being the fastest
moving segment of the homeless population?
A) Families who have children
B) men who are unemployed
C) adolescent Runaways
D) people who have substance use disorders
Answer: A) Families who have children
27. A nurse case manager is providing discharge planning for a client. The nurse is
functioning in which of the following roles when arranging for the delivery of medical
equipment to the clients home.
A) Consultant
B) Coordinator
C) Advocate
D) systems allocators
Answer: B) Coordinator
28. A nurse at a local Health Department is caring for several clients. Which of the following
infection should the nurse report to the State Health Department?
A) Herpes simplex virus
B) Group B streptococcus b hemolytic
C) Chlamydia
D) human papillomavirus
Answer: C) Chlamydia
27. A nurse manager in a local community health agency is creating job description for a new
nurse who will practice community-oriented nursing. Which of the following should the
nurse include in the job description? Select all that apply
A) provide wound care for clients in their homes
B) participate in local Health surveillance activities
C) initiate support groups for parents of autistic children
D) provide health-related education to community groups
E) Investigate potential health and environmental issues

Answer: C) initiate support groups for parents of autistic children
D) provide health-related education to community groups
28. The community health nurse is interviewing a client who reports intimate partner abuse.
Which of the following actions should the nurse take?
A) Assist the client to create a plan of Escape
B) ask 3 nurses of the same gender as the client to participate in the interview
C) communicate disapproval of the partners actions
D) record a summary of the clients description of the event
Answer: D) record a summary of the clients description of the event
29. A nurse is caring for a client who is having difficulty performing activities of daily living.
The nurse is functioning in which of the following rules when arranging for an occupational
therapist to visit the client?
A) Administrator
B) nurse consultant
C) case manager
D) Clinician
Answer: C) case manager
30. A nurse in a mobile Health Clinic is caring for a client who requires a tetanus
immunization and is accompanied by his daughter. The client does not speak the same
language as the nurse. Which of the following actions should the nurse take?
A) Arrange for the member of the client’s community to interpret the teaching
B) identify the clients spoken dialect prior to contacting an interpreter
C) have the clients daughter communicate information about the procedure
D) use professional terminology when providing education prior to the procedure
Answer: B) identify the clients spoken dialect prior to contacting an interpreter
31. An occupational health nurse is discussing health promotion with a client who has a
history of obesity. Which of the following comments indicates the client is using
rationalization as a coping mechanism?
A) I am obese because it is in my genes
B) I have difficulty resisting the items in vending machines

C) I know you don't like me because I am obese
D) I have lots of health problems from being obese
Answer: A) I am obese because it is in my genes
32. A home health nurse is caring for a client who has chemotherapy induced nausea that has
been resistant to relief from pharmacological measures. Which of the following interventions
should the nurse initiate?
A) Assist the client and using guided imagery
B) maintain the head of the bed in the elevated position after eating
C) provide steps of room temperature ginger ale between meals
D) offer 120 ml of cold 2% milk as a meal replacement
E) using seasonings to enhance the flavor of foods
Answer: A) Assist the client and using guided imagery
B) maintain the head of the bed in the elevated position after eating
E) using seasonings to enhance the flavor of foods
33. A parish nurse is counseling a family following a client's recent diagnosis for heart
disease. Which of the following actions should the nurse take first?
A) Discuss the benefits of eating a well-balanced diet with the client's family
B) assist the client and the clients partner with finding an affordable exercise program
C) Ask family members about the impact of the disease and relationships within the family
D) offer to accompany the client and the client partner during healthcare provider visits
Answer: C) Ask family members about the impact of the disease and relationships within the
family
34. A school nurse is playing safety education for a group of adolescents. The nurse should
give priority to which of the following topics as the leading cause of death for this age group?
A) Sports Injury prevention
B) Motor Vehicle Safety
C) gun safety
D) Substance Abuse Prevention
Answer: B) Motor Vehicle Safety

35. A nurse is serving on a state task force for disaster planning. The nurse is engaging a
disaster preparedness effort when performing which of the following actions?
A) Organizing a mass casualty drill for community members
B) function as a manager at a temporary shelter
C) assisting with the identification of a biological agent
D) implementing a disaster triage plan with local medical facility
Answer: A) Organizing a mass casualty drill for community members
36. During a home health visit, a school-age child who has muscular dystrophy confides in
the nurse that he was struck by his parent. Which of the following actions should the nurse
take first?
A) Enroll the parent and anger management classes
B) check the child for injuries
C) report the incident to the local authorities
D) refer the parent to a Social Service Agency
Answer: B) check the child for injuries
37. A nurse is preparing an educational program about breastfeeding for a group of new
parents. The nurse should use which of the following is structural strategies to promote
psychomotor learning?
A) facilitated Discussion Group about the benefits of breastfeeding
B) provide dolls for the participants to demonstrate positioning
C) show the group of video on breastfeeding techniques
D) review flashcards identify holding techniques with the group
Answer: B) provide dolls for the participants to demonstrate positioning
38. A Community Health Clinic nurse manager is reviewing the incidence rate of chlamydia
in the state. In a given year 3144 new cases were reported and the population was estimated
at 325986. Which of the following is the incidence rate in the state for the year?
A) about 10 reported cases per 1000 population
B) about three reported cases per 10,000 population
C) about 300 reported cases per 100,000 population
D) about one reported case per 10,000 population
Answer: A) about 10 reported cases per 1000 population

39. An occupational health nurse is assisting agricultural workers for acute effects of
pesticide exposure. Which of the following findings should the nurse expect?
A) Dizziness
B) Oliguria
C) Diplopia
D) Hypoglycemia
Answer: A) Dizziness
40. The nurses working with the case manager for a client who participates in the health
maintenance organization. The nurse should identify that the health maintenance organization
provides which of the following payment structures?
A) The client is participating a fee for service healthcare insurance program
B) the provider is paid a fixed sum for the client on a monthly basis or yearly basis
C) the client pays the insurer of percentage of the total cost for each service rendered by the
provider
D) to provide our bills the client directly for predetermined percentage of the cost of services
Answer: B) the provider is paid a fixed sum for the client on a monthly basis or yearly basis
41. A newly-hired occupational health nurse is assisting hazards in the work environment.
Which of the following actions will help the nurse detect potential physical hazards?
A) identify industrial toxins that are present in the environment
B) survey workers about job-related emotional stress
C) track rates of illness caused by infection among employees
D) measure noise levels at various locations in the facility
Answer: D) measure noise levels at various locations in the facility
42. My client arrives at a mental health clinic and tells the nurse she has no purpose in life.
Which of the following is the nurses priority response?
A) How long have you been feeling this way?
B) Tell me what is going on with you right now
C) do you really think your life has no purpose?
D) Have you been thinking about harming yourself?
Answer: D) Have you been thinking about harming yourself?

43. In the last month, three cases of tuberculosis have been referred to the health department.
Which of the following is a priority information for the community health nurse to obtain
from each client?
A) Household members
B) health history
C) Demographics
D) Occupation
Answer: A) Household members
44. A nurse is assessing an outbreak of mumps among school-age children. Using that
epidemiological triangle, The nurse should recognize that which of the following is the host?
A) The virus
B) the vaccine
C) the children
D) the school
Answer: C) the children
45. A nurse is working in an infectious disease clinic is caring for a client who has a new
diagnosis of lyme disease. Which of the following agencies is responsible for voluntarily
reporting cases of the disease to the Center for Disease Control and prevention?
A) State Health Department
B) Office of the Surgeon General
C) local Red Cross chapter
D) hospital infection control Department
Answer: A) State Health Department
46. A nurse is providing education to a group of adolescents who are pregnant and attending
High School. Which of the following information should the nurse include in the teaching?
A) The incidence of higher birth weight infants is higher in adolescent pregnancy
B) pregnant adolescents need to gain less weight than adult mothers
C) Caffeinated beverages should be replaced with caffeine-free beverages
D) the need for supplemental folic acid is greatest during the third trimester
Answer: C) Caffeinated beverages should be replaced with caffeine-free beverages

47. A nurse is caring for a client who is homeless. Which of the following actions should the
nurse take first?
A) Develop client teaching using a variety of strategies
B) discuss the risks of being homeless with the client
C) determine the client's understanding of her living situation
D) assist the client to develop goals for obtaining shelter
Answer: C) determine the client's understanding of her living situation
48. A nurse is working to reduce individual and family violence in the local community.
Which of the following actions by the nurse demonstrates a primary prevention strategy to
achieve this goal?
A) Assessing a family for marital Discord
B) providing treatment for a young adult who has substance use disorder
C) teaching parenting techniques to new parents
D) conducting counseling for at-risk parents
Answer: C) teaching parenting techniques to new parents
49. A community health nurse is providing screening for lipid disorders. Which of the
following is the primary goal of this activity?
A) Client enrollment and prevention programs
B) early detection of disease
C) identification of family history of medical problems
D) promotion of appropriate Lifestyle Changes
Answer: D) promotion of appropriate Lifestyle Changes
50. A nurse is providing teaching to a 50 year old female client. Which of the following
statements should the nurse include in the teaching?
A) You should have a complete eye examination every two years until the age of 64
B) you should have your fasting blood glucose level checked every 6 years
C) you should have your hearing screened every 5 years
D) you should have your stool tested for blood every other year until the age of 74
Answer: A) You should have a complete eye examination every two years until the age of 64

51. A community health nurse is planning a program for adolescents about preventing STIs.
Which of the following actions should the nurse take first?
A) Establish methods to evaluate program outcomes
B) obtain visual aids that feature adolescence
C) provide computer based education
D) collect data to identify barriers to learning
Answer: D) collect data to identify barriers to learning
52. A community health nurse is planning an educational program for a group of women who
are post-menopausal. which of the following outcomes is appropriate for this program?
A) Clients will schedule bone density screens
B) clients will start hormone replacement therapy
C) clients will arrange for a mammogram every 3 years
D) clients will significantly decrease caloric intake
Answer: A) Clients will schedule bone density screens
53. A home health nurse manager is caring for a client who has methicillin-resistant
staphylococcus aureus. Which of the following actions should the nurse take?
A) remove fresh flowers from the clients room
B) double bag soil dressing in polyethylene bags
C) wear a mask when within 3 feet of the client
D) Advise the client to use a HEPA filter in the house
Answer: A) remove fresh flowers from the clients room
54. A nurse is counseling a client who has a new diagnosis of chlamydia. Which of the
following information should the nurse include in teaching?
A) Notify anyone with whom you had sexual contact over the past 2 months
B) you might experience painful urination until the infection has resolved
C) once you complete treatment, you'll have an acquired immunity against chlamydia
D) you will need to take an antiviral medication for 30 days
E) you should avoid sexual contact until therapy is complete
Answer: A) Notify anyone with whom you had sexual contact over the past 2 months
E) you should avoid sexual contact until therapy is complete

55. A community health nurse working with a group of homeless veterans who has posttraumatic stress disorder. Which of the following interventions should the nurse implement?
A) Change the meeting sites frequently
B) teach the clients to practice deep breathing exercises
C) provide coffee and snacks during the meetings
D) avoid discussing the traumatic events experienced by the veterans
Answer: B) teach the clients to practice deep breathing exercises
56. A clinic nurse is assessing a client who has the measles. Which of the following findings
should the nurse expect?
A) Muscle aches and tenderness
B) persistent low-grade temperature
C) rash confined to the trunk of the body
D) koplik spots inside the mouth
Answer: D) koplik spots inside the mouth
57. A nurse at a shelter assisting with client triage after tornado destroyed a community.
Which of the following clients should receive Priority Care?
A) A school-age client who has a head abrasion
B) an adult client who is short of breath
C) an infant client who is crying
D) an older adult client who has a fractured arm
Answer: B) an adult client who is short of breath
58. A nurse is triaging clients who were involved in a commuter train crash. Which of the
following clients should the nurse choose for transport to the emergency department first?
A) A client who has a fracture of the humerus with a 2 + radial pulse in the affected arm
B) and ambulatory client who has a nosebleed and reports feeling dizzy
C) A client who has full thickness burn injury over 30% of his total body surface area
D) a client who is exhibiting agonal respirations with fixed dilated pupils
Answer: C) A client who has full thickness burn injury over 30% of his total body surface
area

59. A government official reports to the health department that an employee was possibly
exposed to Anthrax. Which of the following actions should the public health nurse take?
A) Refer co-workers who might have been exposed to a provider for prophylactic antibiotics
B) Alert all of the family members of co-workers about their possible exposure to anthrax
C) instruct the client to wear a mask at work
D) place the employee under quarantine for 14 days
Answer: B) Alert all of the family members of co-workers about their possible exposure to
anthrax
60. A home health nurse is visiting a client who has had a stroke 2 months ago. Which of the
following findings should the nurse report to the interprofessional care team?
A) the client Bears weight on her arms when using the crutches
B) the clients caregiver bills a pill organizer weekly
C) the client coughs when swallowing her medications
D) the client dresses her affected side first
Answer: C) the client coughs when swallowing her medications